Dilatation of Asymmetric Vortex Vein in Central Serous Chorioretinopathy
Dilatation of Asymmetric Vortex Vein in Central Serous Chorioretinopathy
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DOI：
10.1016/j.oret.2017.05.013
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发表时间：
2018-02-01
影响因子：
4.5
通讯作者：
Kishi, Shoji
中科院分区：
文献类型：
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作者：
Hiroe, Takashi;Kishi, Shoji
目的：描述正常对照眼和中心性浆液性脉络膜视网膜病变 (CSC) 眼的外脉络膜血管特征。设计：前瞻性病例对照研究。参与者：35 名急性 CSC 患者的 38 只眼睛和 39 名年龄匹配的正常受试者。方法：进行扫描源光学相干断层扫描，获取两组后极部的 B 扫描和正面图像。所有CSC患者均进行荧光素血管造影（FA）和吲哚菁绿血管造影（ICGA）。主要指标：确定正常对照和患者的enface和B扫描图像中的外脉络膜血管模式，以及enface图像与FA图像中的染料渗漏和ICGA图像中的高渗透性之间的关系。结果：Enface和ICGA图像显示2条脉络膜引流路线，为患者提供服务。后极的上半部和下半部。正常人39只眼中有24只眼（62%）外脉络膜血管对称分布； 15只眼（38%）的外脉络膜血管分布不对称。 35 名 CSC 患者的全部 38 只眼睛 (100%) 均出现不对称。外脉络膜血管在正面和ICGA图像上均出现涡静脉。在患有 CSC 的眼睛中，主要涡静脉服务于黄斑区（9 只眼）或后极（24 只眼）或延伸到血管弓之外（5 只眼）。正常对照中主涡静脉相对扩张，但 CSC 中显着扩张，黄斑区远端突然扩张。 FA图像上的染料渗漏部位和ICGA图像上的渗透性过高的部位对应于扩张的优势涡静脉。结论：不对称涡静脉的存在是正常受试者中的常见变异（38％）；这种不对称性在 CSC 的所有眼睛 (100%) 中均可见。 CSC 中的主涡静脉显着扩张。主要涡静脉的充血可能会增强黄斑区有窗脉络膜毛细血管的通透性。不对称的主导涡静脉似乎是 CSC 的诱发因素。 (C) 2017 年美国眼科学会
Purpose: To characterize the outer choroidal vessels in normal control eyes and those with central serous chorioretinopathy (CSC).Design: Prospective case-control study.Participants: Thirty-eight eyes of 35 patients with acute CSC and 39 age-matched normal subjects.Methods: Swept-source optical coherence tomography was performed to obtain B-scan and en face images in the posterior pole in both groups. All patients with CSC underwent fluorescein angiography (FA) and indocyanine green angiography (ICGA).Main Outcome Measures: Ascertainment of the patterns of the outer choroidal vessels in the en face and B-scan images in normal controls and patients, and the relationship between the en face images and dye leakage in the FA images and hyperpermeability in the ICGA images.Results: En face and ICGA images showed 2 choroidal drainage routes that served the upper and lower halves of the posterior pole. Twenty-four of the 39 eyes (62%) of the normal subjects had symmetrically distributed outer choroidal vessels; 15 eyes (38%) had asymmetrically distributed outer choroidal vessels. Asymmetry was seen in all 38 eyes (100%) of the 35 patients with CSC. The outer choroidal vessels all had vortex veins on en face and ICGA images. In eyes with CSC, a dominant vortex vein served the macular region (9 eyes) or the posterior pole (24 eyes) or extended beyond the vascular arcades (5 eyes). Dominant vortex veins were relatively dilated in normal controls but dilated markedly in CSC, with the distal ends in the macular region abruptly dilated. The sites of dye leakage on the FA images and hyperpermeability on the ICGA images corresponded to the dilated dominant vortex veins.Conclusion: The presence of an asymmetric vortex vein was a common variation (38%) in normal subjects; this asymmetry was seen in all eyes (100%) with CSC. Dominant vortex veins were dilated markedly in CSC. Congestion of the dominant vortex veins might enhance the permeability of fenestrated choriocapillaris in the macular region. Asymmetric dominant vortex veins appear to be a predisposing factor for CSC. (C) 2017 by the American Academy of Ophthalmology