目的：研究光学相干断层扫描血管成像(OCTA)在脉络膜裂伤中的诊断价值，并总结其OCTA影像特征。

方法：回顾分析我院确诊为脉络膜裂伤患者的临床资料，共25例25眼，所有患者均接受眼底照相、荧光素眼底血管造影(FFA)、吲哚菁绿血管造影(ICGA)、频域OCT和OCTA检查。

结果：所有患者眼底检查可见病灶多位于黄斑区或视盘颞侧，呈弧形黄白色条纹，周围可伴有视网膜脉络膜水肿和视网膜下出血。FFA早期可见裂伤呈弧形透见荧光，晚期荧光着染； 当继发脉络膜新生血管(CNV)时，活动性CNV呈高荧光渗漏。频域OCT可见RPE层和脉络膜毛细血管层反射断裂，临近处的组织反射增强，视网膜下可见小团状高反射隆起。OCTA可见脉络膜裂伤的肉芽组织在外层视网膜和脉络膜毛细血管层血流图中表现为具有“条纹形态”的弧形高反射； 在断层B扫描(B-scan)中表现为“团状”的向内隆起或向外凹陷，内部具有血流信号。当继发CNV时，在外层视网膜和脉络膜毛细血管层的血流图中可见明确的血管形态，多呈团状，从形态上与脉络膜裂伤的肉芽组织不相同。

结论：脉络膜裂伤的修复性肉芽组织与继发性CNV病灶在OCTA中虽然同样呈“团状隆起”并具有血流信号，但两者的形态和组织成分均有明显差异。通过OCTA分层显示以及对病灶细节形态上的观察，可以提高脉络膜裂伤继发CNV的诊断率。

METHODS: We selected 25 patients(25 eyes)whom were diagnosed as choroidal rupturein in this retrospective observational case. All patients underwent fundus photography, fundus fluorescein angiography(FFA), indocyannine green angiograph(ICGA), spectral domain optical coherence tomography(SD-OCT)and OCTA examinations.

RESULTS: All the patients showed the lesions were mostly located in the macular area or on the temporal side of the optic disc, with a yellow-white arc hyperreflexia with stripes shape, it can be accompanied by retinal choroidal edema and subretinal hemorrhage. In the early stage of FFA, it showed a curved shape window defect of choroidal rupture, and fluorescent staining in the late stage. When secondary to choroidal neovascularization(CNV), the active CNV showed a hyperfluorescence leakage. SD-OCT showed the reflex of outer retina and choroidal capillary layer were ruptured, the reflex of the surrounding tissue were reinforced, the subretinal small cluster hyperreflexia can be seen. The granulation tissue showed an arc hyperreflexia with “stripe shape” in the outer retinal and choroid capillary layer of OCTA angiogram image. On the B-scan, it showed an inwardly bulge or outwardly recess shap, with blood flow signal inside. When secondary to CNV, vascular morphology can be seen clearly, most of them were cluster shape, which is different from the granulation tissue.

CONCLUSION: Although the granulation tissue and CNV of choroid rupture showed cluster shap and blood flow signal on OCTA, there were significant differences in morphology and tissue composition between them. Through the display of OCTA stratification and the detailed observation of the lesion, the diagnosis rate of secondary CNV in choroidal rupture can be improved.