特発性中心性漿液性脈絡膜症の螢光眼底血管造影法所見

Fluorescein angiographic features of idiopathic central serous choroidopathy

　本症79例81眼の螢光眼底血管造影所見から，定型型，急性網膜色素上皮炎型，およびacutc posterior multifocal placoid pigment epitheliopathy様あるいは脈絡膜三角形症候群様型の3型に分類された．その結果，（1）本症にみられる定型型の螢光漏出点も脈絡膜前毛細血管細動脈の軽度，一過性虚血（スパズム）によることが暗示された．（2）本症にみられる3型の螢光像は，侵される脈絡膜の動脈（あるいは後毛様動脈）の部位，数，スパズムの程度および持続時間に左右されるものと考えられる．

We attempted to determine the role of choroidal ischemia in the development of leaking spots in cen-tral serous choroidopathy through angiographic analysis of 91 eyes of 79 patients which fulfilled the diagnostic criteria.

The fluorescein angiographic manifestations were classified into three types : 1) classic type, showing only mushroom or inkblot types of leakage, 2) acute retinal pigment epitheliitis type, and 3) the type simulating choroidal triangular syndrome or APMPPE. In the latter two types, the classical leaking spots were observed not only in the affected areas but also in other apparently intact retinal areas. These accessary leaking spots disappeared without scar formation during the course of the disease. These findings seemed to suggest that the leaking spots in the classic type might also be due to the presence of acute, mild and transient choroi-dal ischemia, probably spastic in nature.

It also appeared that the three types of angio-graphic manifestations might depend upon various factors, e.g. the size and number of affected choroidal arterioles and severity or duration of the choroidal ischemia.