摘要目的:分析不同性别中心性浆液性脉络膜视网膜病变(CSC)患者扫频源光学相干断层扫描(SS-OCT)和扫频源光学相干断层扫描血管成像(SS-OCTA)的影像学特征。方法:采用横断面研究设计，纳入2021年9月至2024年8月于郑州大学第一附属医院眼科初次确诊且未接受治疗的CSC患者141例155眼。根据性别分为女性组47例52眼和男性组94例103眼，分别行SS-OCT及SS-OCTA检查，记录视网膜色素上皮脱离(PED)、扁平不规则PED(FIPED)、视网膜和脉络膜高反射灶、局灶性脉络膜凹陷(FCE)、肥厚性玻璃膜疣、脉络膜新生血管(CNV)、浆液性视网膜脱离(SRD)及视网膜下纤维蛋白的发生率，以及涡静脉吻合和涡静脉不对称扩张情况。采用设备自带软件测量中心凹下脉络膜厚度(SFCT)、黄斑中心凹厚度(CMT)、SRD高度和宽度、PED高度和宽度、脉络膜血管体积(CVV)、脉络膜血管指数(CVI)。结果:女性组平均年龄为(48.64±10.18)岁，明显大于男性组的(43.76±8.60)岁，差异有统计学意义( t＝2.985， P＝0.003)。男性组的SFCT和CVV分别为(542.06±127.47)μm和3.97(3.46，4.33)mm 3，明显大于女性组的(474.12±120.36)μm和3.31(2.91，4.13)mm 3，差异均有统计学意义( t＝-3.191， P＝0.002； Z＝-3.106， P＝0.002)；男性组的SRD高度和CVI分别为163.70(87.10，239.90)μm和0.31(0.28，0.34)，明显低于女性组的216.90(128.40，291.88)μm和0.32(0.30，0.36)，差异均有统计学意义( Z＝-2.236， P＝0.025； Z＝-2.362， P＝0.018)；亚组分析显示，在年龄<50岁患者中，不同性别组间SFCT、CVV和CVI差异均有统计学意义( t＝-2.373， P＝0.019； Z＝-2.169， P＝0.030； Z＝-2.142， P＝0.032)，而在年龄≥50岁患者中，2个组间SFCT、CVV和CVI差异均无统计学意义( t＝-0.863、-0.503、-1.588；均 P>0.05)；男性组患者脉络膜高反射灶的发生率为55.3%(57/103)，明显高于女性组的36.5%(19/52)，差异有统计学意义( χ2＝4.888， P＝0.027)，男性组FIPED发生率为31.1%(32/103)，明显低于女性组的50.0%(26/52)，差异有统计学意义( χ 2＝5.289， P＝0.021)。男性组涡静脉吻合率为84.5%(87/103)，明显高于女性组的69.2%(36/52)，差异有统计学意义( χ 2＝4.896， P＝0.027)。Logistic回归分析结果显示，男性是发生脉络膜高反射灶及涡静脉吻合的危险因素( OR＝2.410， P＝0.017； OR＝2.686， P＝0.020)，而年龄增长是FIPED发生的危险因素( OR＝1.059， P＝0.004)。 结论:与女性相比，男性CSC患者脉络膜厚度增加，脉络膜血管扩张且灌注增强，这些特征在年龄<50岁患者中表现更明显；男性是CSC患者发生脉络膜高反射灶和涡静脉吻合的危险因素。

abstractsObjective:To analyze the imaging characteristics of swept-source optical coherence tomography (SS-OCT) and swept-source optical coherence tomography angiography (SS-OCTA) between male and female patients with central serous chorioretinopathy (CSC).Methods:A cross-sectional study was conducted. A total of 141 patients (155 eyes) with newly diagnosed and untreated CSC at the Ophthalmology Department of the First Affiliated Hospital of Zhengzhou University from September 2021 to August 2024 were enrolled. Participants were divided into the female group (47 patients, 52 eyes) and the male group (94 patients, 103 eyes) according to their sex. All subjects underwent SS-OCT and SS-OCTA examinations. The incidences of pigment epithelial detachment (PED), flat irregular PED (FIPED), retinal and choroidal high-reflective foci, focal choroidal excavation (FCE), pachydrusen, choroidal neovascularization (CNV), serous retinal detachment (SRD), and subretinal fibrin were recorded, as well as the presence of vortex vein anastomosis and vortex vein asymmetric dilation. Device-built software was used to measure subfoveal choroidal thickness (SFCT), central macular thickness (CMT), SRD height and width, PED height and width, choroidal vascular volume (CVV), and choroidal vascularity index (CVI). This study followed the Declaration of Helsinki, and the study protocol was approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University (No. 2024-KY-1660). All subjects were fully informed of the study content and voluntarily signed the informed consent form.Results:The average age of the female group was (48.64±10.18) years, which was significantly greater than (43.76±8.60) years of the male group ( t=2.985, P=0.003). The SFCT and CVV of the male group were (542.06±127.47)μm and 3.97(3.46, 4.33) mm 3, which were significantly greater than (474.12±120.36)μm and 3.31(2.91, 4.13) mm 3 of female group, respectively ( t=-3.191, P=0.002; Z=-3.106, P=0.002). The SRD height and CVI of the male group were 163.70(87.10, 239.90)μm and 0.31(0.28, 0.34), which were significantly lower than 216.90(128.40, 291.88)μm and 0.32(0.30, 0.36) of the female group, respectively ( Z=-2.236, P=0.025; Z=-2.362, P=0.018). No significant differences in CMT, PED height and width, or SRD width were found between the two groups (all P>0.05). Subgroup analysis showed that among patients aged <50 years, there were significant differences in SFCT, CVV, and CVI between the two groups ( t=-2.373, P=0.019; Z=-2.169, P=0.030; Z=-2.142, P=0.032), and no such differences were observed in patients aged ≥50 years ( t=-0.863, -0.503, -1.588; all P>0.05). The incidence of choroidal high-reflective foci in the male group was 55.3%(57/103), which was significantly higher than 36.5%(19/52) in the female group ( χ 2=4.888, P=0.027), and the incidence of FIPED in the male group was 31.1%(32/103), which was significantly lower than 50.0%(26/52) in the female group ( χ 2=5.289, P=0.021). The rate of vortex vein anastomosis in the male group was 84.5%(87/103), which was significantly higher than 69.2% in the female group ( χ 2=4.896, P=0.027). Logistic regression analysis identified male gender as a significant risk factor for choroidal high-reflective foci and vortex vein anastomosis (odds ratio [ OR]=2.410, P=0.017; OR=2.686, P=0.020), while increasing age was a significant risk factor for FIPED ( OR=1.059, P=0.004). Conclusions:Compared with female patients, male CSC patients exhibit increased choroidal thickness, choroidal vascular dilation, and higher perfusion. These characteristics are more pronounced in patients under 50 years of age. Male gender is a risk factor for the occurrence of choroidal high-reflective foci and vortex vein anastomosis in CSC patients.