慢性中心性浆液性脉络膜视网膜病变(cCSC)以广泛的脉络膜视网膜异常为特征，包括脉络膜血管扩张及其引发的弥漫性视网膜色素上皮病变和浆液性视网膜脱离，常累及黄斑区，引起视功能损害。传统观点认为其可能由急性CSC演变而来，但近期研究显示两者在临床上存在明显差异。其病情反复、迁延，预后较差。随着光学相干断层扫描血管造影(OCTA)、超广角成像和en face重建成像等新多模式影像(MMI)技术的出现和人工智能及机器学习的发展，更多有意义的cCSC影像学特征不断出现。文章详细介绍了cCSC在眼底成像、眼底自发荧光(FAF)、光学相干断层扫描(OCT)、眼底荧光素血管造影(FFA)、吲哚菁绿血管造影和OCTA等影像技术中的表现，并探讨了人工智能在识别CSC分类及其OCT 生物标志物等方面的应用。不同影像技术在cCSC的诊断和研究中各有优势，如FAF可能是评估疾病进展及变化的有效手段，OCT可更直观地观察视网膜结构的改变，FFA是识别渗漏点的重要检查手段，而OCTA可能是评估脉络膜微循环的的最佳手段等。这些MMI研究进展为深入了解cCSC的病理生理机制及临床特征提供了重要线索，有助于提高诊断的准确性和效率，改善患者的预后和生活质量。

Chronic central serous chorioretinopathy (cCSC) is characterized by extensive retinochoroidal abnormalities. This includes difuse retinal pigment epitheliopathy and serous retinal detachment associated with choroidal vasodilatation, ofen involving the macula and cause visual impairment. It was originally considered that it might evolve from acute CSC, but recent studies have shown significant clinical differences between the two. It tends to recur, be prolonged, and have an unfavorable prognosis. With the advent of new multimodal imaging (MMI) techniques such as optical coherence tomography angiography (OCTA), ultra-wide-feld imaging, and en face reconstruction imaging, along with the advancement of artificial intelligence and machine learning, more significant cCSC imaging characteristics have been constantly emerging. Tis article provides a comprehensive overview of cCSC’s imaging features across various modalities, including fundus photography, fundus autofluorescence (FAF), optical coherence tomography (OCT), fuorescein angiography (FFA), indocyanine green angiography, and OCTA. It also explores the application of artifcial intelligence in identifying CSC classifications and OCT biomarkers. Different imaging techniques have their own advantages in the diagnosis and study of cCSC, such as FAF being an efective means to assess disease progression and changes, OCT providing a more intuitive observation of retinal structural changes, FFA being an important tool for identifying leakage points, and OCTA possibly being the best means to assess choroidal microcirculation. Tese MMI research advancements ofer crucial insights for clinicians, aiding in more accurate diagnosis and efective treatment, thereby potentially improving patient outcomes and quality of life.

目的：评估炎非感染性葡萄膜炎继发炎性脉络膜新生血管(inflammatory choroidal neovascularization, iCNV)的临床特征及眼底多模式影像表现。方法：采用回顾性观察性研究，采用眼底荧光素血管造影(fundus fluorescein angiography, FFA)、吲哚菁绿血管造影(Indocyanine green angiography, ICGA)、谱域相干光断层扫描(spectral domain optical coherence tomography, SD-OCT)联合光学相干断层扫描血管成像(optical coherence tomography angiography, OCTA)等多种眼底影像学方法，对纳入患者的眼底进行检查，分析非感染性iCNV的面积、分型、位置及形态等影像学特征与临床特征的关系。结果：研究共纳入39例患者，对48只患眼中的51处iCNV病灶进行了评估。纳入患者年龄为(35.28±13.62)岁。其中3例患眼出现多灶性CNV。SD-OCT显示92.16%(47/51)的iCNV为2型CNV，17.65%(9/51)的iCNV出现海绵征，13.72%(7/51)的iCNV伴有局灶脉络膜凹陷。ICGA造影期间，74.50%的iCNV病灶(38/51)伴有弱荧光病灶，25.49%的病例(13/51)显示脉络膜高通透性表现。OCTA enface图像显示iCNV形态多样，包括焦点状(15例，29.41%)、盘状/海扇状(16例，31.37%)、枯树状(9例，17.65%)、星状(9例，17.65%)及弥漫网状(2例，3.92%)。其中，枯树状及星状iCNV提示iCNV为非活动性(P＜0.01)。结论：非感染性iCNV与炎性病灶关系密切，在SD-OCT，ICGA上皆具特征性的影像表现。OCTA能直观地观察到iCNV的形态。这些多模式影像特征为临床医生提供了对于非感染性iCNV重要的鉴别诊断依据，有助于制定有效的诊疗方案。

Objective: To evaluate the clinical characteristics and multimodal imaging features of non-infectious inflammatory choroidal neovascularization (iCNV). Methods: In this study retrospective, observational study, multimodal imaging examinations, including fluorescein angiography (FFA), indocyanine green angiography (ICGA), spectral-domain optical coherence tomography (SD-OCT), and optical coherence tomography angiography (OCTA), were used to observe the morphology of non-infectious iCNV in patients diagnosed with uveitis. The area of iCNV, CNV types, CNV morphology and other imaging characteristics were further analyzed. Results: A total of 39 patients were included, with 48 affected eyes and 51 iCNV were identified. The average age of the included patients was 35.28±13.62 years. Among the affected eyes, 3 presented with multifocal CNV, and 92.16% of iCNV were classified as type 2 CNV. iCNV exhibited diverse morphologies, including focal-like pattern (15 cases, 29.41%),sea-fan pattern(16 cases, 31.37%), dead-tree pattern CNV(9 cases, 17.65%), stellar pattern (9 cases, 17.65%), and diffuse reticular (2 cases, 3.92%). Notably, tree-like and stellar pattern iCNV showed a significant correlation with non-active CNV (P < 0.01). Conclusions: Non-infectious iCNV is closely related to inflammatory lesions, exhibiting characteristic imaging features on SD-OCT and ICGA. OCTA allows for direct observation of the morphology of iCNV. These multimodal imaging characteristics provide important diagnostic criteria for clinicians, aiding in the formulation of effective treatment plans.

随着多模式影像技术的应用，年龄相关性黄斑变性(age related macular degeneration, AMD)的一种特殊亚型：表皮玻璃疣(cuticular drusen)被发现，其与AMD尤其是非渗出性AMD又称干性(dry)AMD进展密切相关。但目前聚焦于AMD合并表皮玻璃疣的多模式影像特点等的相关文献较少，因此研究和阐明表皮玻璃疣的多模式影像特点、与其他AMD亚型玻璃疣的鉴别诊断、病理生理机制、治疗方法等具有重要的临床意义。运用多模式影像可以看到表皮玻璃疣呈双眼对称的无数散在的大小均匀的黄色视网膜下结节，典型的“星空状”荧光素钠眼底血管造影(fundus fluorescein angiography, FFA)表现， 以及光学相干断 层成像(optical coherence tomography, OCT)中视网膜色素上皮(retinal pigment epithelium, RPE)和Bruch膜之 间的锯齿状隆起。AMD合并表皮玻璃疣患者的分布特点个体差异很大，容易与AMD其他亚型的玻璃疣混淆，需要与硬性玻璃疣、软性玻璃疣、大胶质玻璃疣、Sorsby眼底营养不良(Sorsby's fundus dystrophy , SFD) 等相鉴别。研究表明表皮玻璃疣具有遗传性的类似动脉粥样硬化的发病机制，与RPE分泌的大型脂蛋白颗粒的堆积密切相关。未来可能会有针对补体系统的药物用于延缓表皮玻璃疣相关病变的进展。文章就表皮玻璃疣的临床表现、多模式影像的典型特点、鉴别诊断、遗传学基础、病理生理学发病机制、 并发症以及临床诊疗策略进行综述。

With the application of multimodal imaging techniques, a specific subtype of age-related macular degeneration (AMD),
known as cuticular drusen, has been identified. This subtype is closely associated with the progression of AMD, particularly non-exudative AMD, also referred to as dry AMD. However, there is a scarcity of literature focusing on the multimodal imaging characteristics of AMD combined with cuticular drusen. Therefore, studying and elucidating the multimodal imaging features of cuticular drusen, its differential diagnosis from other AMD subtypes of drusen, pathophysiological mechanisms, and treatment methods holds significant clinical importance. Multimodal imaging reveals cuticular drusenas numerous, symmetrical, evenly sized, yellow subretinal nodules in both eyes, exhibiting a typical "stars-in-the-sky" appearance on fluorescein angiography (FFA) and zigzag elevations between the retinal pigment epithelium (RPE) and Bruch's membrane on optical coherence tomography (OCT). The distribution characteristics of AMD patients with cuticular drusen vary greatly among individuals and can easily be confused with drusen from other AMD subtypes, so the differentiation from hard drusen, soft drusen, large colloidal drusen, and Sorsby's fundus dystrophy (SFD) is necessary. Studies suggest that cuticular drusen have a genetic, atherosclerosis- like pathogenesis which closely related to the accumulation of large lipoprotein particles secreted by the RPE. Future therapies targeting the complement system maybe employed to delay the progression of cuticulardrusen-related lesions. This article reviews the clinical manifestations, typical multimodal imaging features, differential diagnosis, genetic basis, pathophysiological mechanisms, complications, and clinical management strategies of cuticulardrusen.