背景:随着成像技术的进步,研究人员已经能够确定中心性浆液性脉络膜视网膜病变(CSC)的更独特的影像学特征.然而,现有研究主要集中在50岁及以下的年轻患者,缺乏对老年CSC患者的研究。先前的研究表明,老年CSC患者可能表现出独特的影像学特征,并且其临床预后与年轻患者明显不同。本研究旨在评估视网膜的特征,脉络膜结构,对老年慢性CSC(cCSC)患者进行多模式影像学检查,试图寻找新的发病机制信息。
方法:使用50岁的截止年龄,慢性中心性浆液性脉络膜视网膜病变患者被分为两组:年龄较大和年龄较小.对照组由40名健康人组成,他们的右眼被分配。记录各种临床特征,包括椭球区破裂(EZ-)的发生率,视网膜下液(SRF)中的纤维蛋白,厚皮疣,视网膜下椎间盘样沉积(SDD),色素上皮脱离(PED),双层标志(DLS),和脉络膜脂质球洞。测量外核层(ONL)的厚度,延伸的外感光体段(POS)的长度,SRF的高度和宽度,视网膜毛细血管丛各层的血管密度,黄斑中心厚度(CMT),和中央凹下脉络膜厚度(SFCT)。
结果:老年组女性比例(43.75%)明显高于青年组(22.41%)(p=0.034)。老年组远视程度(1.03±0.73)高于青年组(0.26±1.06),BCVA有显著差异(p=0.05)。SFCT的厚度,CMT,老年组的ONL,老年组感光体外段长度较青年组薄(p<0.05)。脉络膜毛细血管灌注面积(CCPA),黄斑区,在全扫描范围内,老年组的耳旁面积低于青年组(p<0.05)。深毛细血管丛(DCP)的血流密度,中间毛细血管丛(ICP),和整个扫描范围内的浅表毛细血管丛(SCP),黄斑区,老年组的杂音面积低于青年组,但差异无统计学意义。
结论:结论:我们的数据提示患有cCSC的老年患者可能会经历不同的疾病结局.老年cCSC患者表现出更少的性别偏见,视力较差,更严重的结构损伤和脉络膜和视网膜缺血,脉络膜新生血管形成的风险较高。
BACKGROUND: With advancements in imaging technology, researchers have been able to identify more distinctive imaging features of central serous chorioretinopathy (CSC). However, existing research primarily concentrates on young patients aged 50 years and below, leaving a dearth of studies on elderly CSC patients. Previous studies indicate that elderly CSC patients may exhibit unique imaging characteristics and have a clinical prognosis that significantly differs from younger patients. This study aimed to evaluate the characteristics of retina, choroid structure, and blood flow in elderly patients with chronic CSC (cCSC) examined multimode imaging and try to find new pathogenesis information of it.
METHODS: Using a cut-off age of 50 years, patients with chronic central serous chorioretinopathy were divided into two groups: older and younger. The control group consisted of 40 healthy individuals, with their right eyes assigned. Various clinical features were recorded, including the incidence of ellipsoid zone rupture (EZ-), fibrin in the subretinal fluid (SRF), pachydrusen, subretinal drusenoid deposits (SDD), pigment epithelial detachment (PED), double-layer sign (DLS), and choroidal lipid globule cavern. Measurements were taken for the thickness of the outer nuclear layer (ONL), the length of the extended outer photoreceptor segment (POS), the height and width of SRF, the vascular density of each layer of the retinal capillary plexus, the central macular thickness (CMT), and the subfoveal choroidal thickness (SFCT).
RESULTS: The proportion of females in the elderly group (43.75%) was significantly higher than that in the youth group (22.41%) (p = 0.034). The degree of hyperopia in the elderly group (1.03 ± 0.73) was higher than that in the youth group (0.26 ± 1.06), with a significant difference in BCVA (p = 0.05). The thickness of SFCT, CMT, ONL in the elderly group, and the length of photoreceptor outer segment in the elderly group were thinner than those in the youth group (p < 0.05). Choroidal capillary perfusion area (CCPA), macular area, and paramacular area were lower in the elderly group than those in the youth group in the full scan range (p < 0.05). The blood flow densities of deep capillary plexus (DCP), intermediate capillary plexus (ICP), and superficial capillary plexus (SCP) in the whole scan range, macular area, and paramacular area were lower in the elderly group than in the youth group, but the differences were not statistically significant.
CONCLUSIONS: In conclusion, our data suggest that elderly patients with cCSC may experience different disease outcomes. Elderly cCSC patients exhibit less gender bias, poorer vision, more severe structural damage and ischemia in the choroid and retina, and have a higher risk of developing choroidal neovascularization.