眼底影像专栏

中心性浆液性脉络膜视网膜病变的SS-OCT及SS-OCTA的应用及研究进展

Application and progress of swept source optical coherence tomography in choroid-related diseases

:464-470
 
中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)是一种以脉络膜增厚、血管通透性增加为特征的脉络膜谱系疾病,所以对脉络膜的观察对于CSC的监测和治疗非常重要。随着光学相干断层扫描成像(optical coherence tomography,OCT)的发展,对脉络膜的认识有了显著提升,也让我们更深刻地理解了它在眼后段疾病中的重要作用,提高了对各种脉络膜视网膜疾病的诊断能力。近年来,随着扫频源光学相干断层扫描(swept source optical coherence tomography,SS - OCT)及扫频源光学相干断层扫描血流成像(swept source optical coherence tomography angiography,SS - OCTA)的发展,其扫描波长、深度、广度及扫描速度均显著提升,实现了对脉络膜结构的无创定量化评估,推进了对CSC等脉络膜谱系疾病的病理机制的认识和临床管理。文章就近年SS-OCT及SS-OCTA在 CSC 中的应用及研究进展进行总结。主要进展有:发现CSC脉络膜增厚不仅局限于黄斑区,且发现其脉络膜血管及基质成分均显著增加;CSC为双眼受累,而表现为单眼症状;涡静脉回流障碍机制在该疾病中起到关键作用;SS-OCT能进一步对后极部的视网膜下积液进行监测和分析;发现了急性与慢性CSC脉络膜相关参数的改变的不同;最后探究了巩膜机制在该疾病中可能起到的作用。
Central serous chorioretinopathy (CSC) is one of the choroidal spectrum diseases, characterized by choriod thickening and increased vascular permeability. Therefore it is very important to observe choroid, as this allows us to monitor it and formulate an appropriate therapeutic schedule. With the development of optical coherence tomography (OCT), our understanding of choroid has been significantly improved. We have got a deeper insight into its important role in posterior diseases, and also the diagnostic capability for choroidal and retinal diseases has also improved. In recent years, the development of swept source optical coherence tomography (SS-OCT) and swept source optical coherence tomography angiogrphy (SS-OCTA) has further advanced our ability to assess choroidal conditions. These technologies offer enhanced scanning wavelengths, depth, breadth, and scanning speed, enabling non-invasive quantitative assessment of choroidal structures. This has advanced our understanding of the pathophysiological mechanisms and clinical management of CSC and other choroidal spectrum diseases.This review summarizes the application of swept source optical coherence tomography (SS - OCT) and swept source optical coherence tomography angiography (SS - OCTA) in CSC and it’s research progress. The main advancements include: choroidal thickening in CSC is not limited to macular area, both choroidal vascular and stromal components are significantly increased; CSC can affect both eyes, although it often presents with unilateral symptoms; impaired vortex vein outflow plays a key role in the pathogenesis of this disease; SS-OCT can further monitor and analyze subretinal fluid accumulation in the posterior pole; differences in changes in choroidal parameters between acute and chronic CSC have been identified; and finally, the potential role of scleral mechanisms in this disease has been explored.
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  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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