急性CSC黄斑区形态结构与视力和视物变形度的相关性分析

Correlation between macular morphology and visual acuity and visual distortion in acute central serous chorioretinopathy

摘要:

目的：探讨急性中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy，CSC)黄斑区形态结构与视力和视物变形度的相关性。

方法：横断面临床病例对照研究。临床检查并确诊为单眼急性CSC患者38例(CSC组)，并将患者的正常眼38例(对照组)纳入研究。所有受检者均行最佳矫正视力(best corrected visual acuity，BCVA)、裂隙灯显微镜、间接检眼镜、频域光相干断层扫描(OCT)、彩色眼底照相、视物变形评分表(M-charts)检查。其中BCVA统计时转换为最小分辨角对数(LogMAR)记录。将两组平均BCVA、黄斑区中心凹视网膜厚度(central foveal retinal thickness，CFT)和黄斑区中心凹视网膜下液厚度(foveal subretinal fluid thickness，SRF)、黄斑区视网膜下液横径长度、视物变形度(M值)比较，并分析BCVA、CFT和SRF、黄斑区视网膜下液横径长度、M值之间是否具有相关性。

结果：急性CSC组BCVA平均值为0.15±0.15，对照组BCVA平均值为0.12±0.12。急性CSC组CFT为418.89±134.74μm，SRF为286.95±136.77μm，黄斑区视网膜下液横径长度为2926.37±1109.66μm； 对照组的CFT为217.58±12.49μm，SRF为0μm，黄斑区视网膜下液横径长度为0μm。急性CSC组M值为0.86±0.40，其中水平变形度(MH)、垂直变形度(MV)分别为0.99±0.38、0.73±0.43，与MV比较，MH明显加重，差异有统计学意义(t=4.564，P<0.01)。急性CSC组BCVA与M值无相关性(r=-0.124，P>0.05)； 急性CSC组BCVA与SRF和黄斑区视网膜下液横径长度无相关性(r=-0.059、-0.12，P=0.73、0.48)； 急性CSC组的CFT与M值呈正相关(r=0.91，P<0.01)； MV值与黄斑区视网膜下液横径长度呈正相关(r=0.934，P<0.01)； MH值与SRF呈正相关(r=0.949，P<0.01)。

结论：急性CSC组BCVA与CFT、SRF、黄斑区视网膜下液横径长度、视物变形度均无相关性； M值与CFT、SRF及黄斑区视网膜下液横径长度均呈正相关性，其中MV值与视网膜下液横径长度呈正相关，MH值与SRF呈正相关。

Abstract:

AIM: To investigate the correlation between macular morphology and visual acuity and visual deformation in acute central serous chorioretinopathy(CSC).

METHODS: A cross-sectional clinical case-control study was conducted in which 38 patients with acute monocular CSC(CSC group)and 38 normal eyes(control group)were included. The best corrected visual acuity(BCVA), slit lamp microscope, indirect ophthalmoscope, frequency domain optical coherence tomography(OCT), color fundus photography and M-charts were performed in all subjects. The BCVA was converted to the minimum resolution angle LogMAR record when doing statistical. The mean LogMAR, macular retinal thickness(CFT), subretinal fluid thickness(SRF), transverse diameter length of subretinal fluid in macular area and visual deformation(M value)were significantly different between the two groups. The correlation between CFT and SRF, transverse diameter length of subretinal fluid in macular area and M value was analyzed.

RESULTS: The mean BCVA in acute CSC group was 0.15±0.15(LogMAR), that in control group was 0.12±0.12(LogMAR); CFT was 418.89 ±134.74μm in CSC group and SRF was 286.95±136.77μm in CSC group. The length of subretinal fluid transverse diameter in macular area was 2926.37±1109.66μm. CFT in control group was 217.58±12.49μm, SRF was 0, and the transverse diameter of subretinal fluid in macular area was 0. The M value of CSC group was 0.86±0.40, MH and MV were 0.99±0.38, 0.73±0.43, respectively. Compared with MV, MH was obviously aggravated, the difference was statistically significant(t=4.564, P<0.01). There was no correlation between BCVA and the degree of visual deformation in CSC group(r=-0.124, P>0.05). In CSC group, BCVA had no correlation with SRF or the length of subretinal fluid transverse diameter in macular area(r=-0.059, -0.12; P=0.73, 0.48; respectively.)There was a positive correlation between CFT and M value in CSC group(r=0.91, P<0.01). The value of MV was positively correlated with the length of transverse diameter of subretinal fluid in macular area(r=0.934, P<0.01), and the value of MH was positively correlated with SRF(r=0.949, P<0.01).

CONCLUSION: In acute CSC group, BCVA had no correlation with CFT, SRF, macular subretinal fluid transverse length and visual deformability, and visual deformability was positively correlated with CFT, SRF and macular subretinal fluid transverse length; MV was positively correlated with subretinal fluid transverse length, and MH was positively correlated with SRF.