摘要目的 观察中心性浆液性脉络膜视网膜病变(CSC)治疗前后视网膜色素上皮-Bruch膜-脉络膜毛细血管复合体(CBRP-C)中Bruch膜(BM)在光相干断层扫描(OCT)中的分型特征.方法 回顾性病例对照研究.临床确诊为CSC并经激光光凝或半剂量光动力疗法(PDT)治疗的60例患者60只眼纳入本研究.其中,激光光凝治疗51只眼,半剂量PDT治疗9只眼.治疗前后所有患者均采用频域OCT扫描黄斑区,以BM为核心观察指标对CBRP-C行整体观察.根据BM反射带是否显现,将其分为不可辨型BM 和可辨型BM.再根据视网膜色素上皮(RPE)下有无液腔,将可辨型BM分为显型BM和隐型BM.对比分析患者治疗前后CBRP-C中BM分型的变化情况.结果 治疗前,60只眼均为可辨型BM.其中,显型BM 59只眼,占98.3%;隐型BM 1只眼,占1.7%.治疗后1个月,激光治疗组51只眼中,可辨型BM 50只眼,占98.0%;不可辨型BM 1只眼,占2.0%.可辨型BM 50只眼中,显型BM 34只眼,占68.0%;隐型BM 16只眼,占32.0%.PDT治疗组9只眼中,可辨型BM 8只眼,占88.9%;不可辨型BM 1只眼,占11.1%.可辨型BM 8只眼中,显型BM 1只眼,占12.5%;隐型BM 7只眼,占87.5%.结论 CSC患眼治疗前后CBRP-C中BM在OCT中均存在显型BM,但治疗后较治疗前有所好转.

abstractsObjective To observe the types and features of Bruch's membrane (BM) in the choriocapillario-Bruch' s membrane-retinal pigment epithelium complex (CBRP-C) in central serous chorioretinopathy (CSC) by optical coherence tomography (OCT). Methods This is a retrospective case control study. Sixty eyes of 60 patients (43 males, 17 females) with CSC who underwent laser photocoagulation (51 eyes) or half-dose verteporfin photodynamic therapy (9 eyes) were enrolled. The macular area of all the patients was scanned by Spectralis-OCT before and after the treatment, BM was observed as the core indicators of CBRP-C. According to the reflection band, BM was classified into distinguishable BM and indistinguishable BM. The distinguishable BM was classified into phenotype BM (with a sub-RPE fluid cavity) and cryptotype BM (without a sub-RPE fluid cavity). The types and features of BM in CBRP-C of CSC patients before and after the treatment were comparatively analyzed. Results Before the treatment, distinguishable BM were observed in all patients, including 59 eyes (98.3%) with phenotype BM and 1 eye (1.7%) with cryptotype BM. At 1 month after laser photocoagulation, there were, 1/51 eye (2.0%) with indistinguishable BM, and 50/51 eyes (98.0%) with distinguishable BM,including 34 eyes (68.0%) with phenotype BM and 16 eyes (32.0%) with cryptotype BM. At 1 month after half-dose PDT, there were 1/9 eye (11.1%) with indistinguishable BM and 8/9 eyes (88.9%) with distinguishable BM, including 1 eye (12.5%) with phenotype BM and 7 eyes (87.5%) with cryptotype BM. Conclusion The phenotype BM exists in CSC patients before and after the treatment, but it has been improved after treatment.