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中华眼科医学杂志(电子版) ›› 2026, Vol. 16 ›› Issue (01) : 54 -58. doi: 10.3877/cma.j.issn.2095-2007.2026.01.010

综述

光学相干断层扫描成像中脉络膜高反射灶的研究进展
杨悦, 张正威()   
  1. 214002 江苏省无锡市第二人民医院眼科
  • 收稿日期:2026-01-13 出版日期:2026-02-28
  • 通信作者: 张正威
  • 基金资助:
    江苏省科技厅社会发展面上研发项目(BE2022699); 无锡市卫生健康委中青年拔尖人才资助计划项目(BJ2023037); 中国健康促进基金会科研发展公益项目(2025-ZCXY-0455)

Research progress on the choroidal hyperreflective foci on optical coherence tomography

Yue Yang, Zhengwei Zhang()   

  1. Department of Ophthalmology, Wuxi Second People′s Hospital, Wuxi 214002, China
  • Received:2026-01-13 Published:2026-02-28
  • Corresponding author: Zhengwei Zhang
引用本文:

杨悦, 张正威. 光学相干断层扫描成像中脉络膜高反射灶的研究进展[J/OL]. 中华眼科医学杂志(电子版), 2026, 16(01): 54-58.

Yue Yang, Zhengwei Zhang. Research progress on the choroidal hyperreflective foci on optical coherence tomography[J/OL]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2026, 16(01): 54-58.

脉络膜主要为外层视网膜提供营养、清除代谢废物,维持视网膜正常的代谢与生理功能。其结构与功能异常是年龄相关性黄斑变性、遗传性视网膜营养不良等多种视网膜疾病的核心病理环节。近年来,随着光学相干断层扫描(OCT)技术的快速发展与广泛应用,脉络膜细微结构得以清晰呈现,其中脉络膜高反射灶(CHF)是OCT成像中观察到的脉络膜特征性结构。目前,CHF已在正常眼及多种眼病中被检出且被证实可作为潜在生物标志物,在评估脉络膜与视网膜萎缩程度、监测病情活动状态及治疗方案的选择中发挥重要作用。本文中笔者就CHF的定义、影像学特征、形成机制以及近年来在正常眼及各类眼科疾病中的研究进展进行了综述。

The choroid mainly provides nutrition for the outer retina, clears metabolic waste, and maintains normal metabolism and physiological functions of the retina. The structural and functional abnormalities are the core pathological links of various retinal diseases such as age-related macular degeneration and hereditary retinal malnutrition. In recent years, with the rapid development and widespread application of optical coherence tomography (OCT) technology, the fine structure of the choroid has been clearly presented, among which choroidal hyperreflexia (CHF) is a characteristic structure observed in OCT imaging. At present, CHF has been detected in normal eyes and various eye diseases and has been proven to be a potential biomarker, playing an important role in evaluating the degree of choroidal and retinal atrophy, monitoring disease activity status, and selecting treatment plans. The definition, imaging features, formation mechanisms, and recent research progress of CHF in normal eyes and various ophthalmic diseases were reviewed in this paper.

图1 葡萄膜炎患眼谱域光学相干断层扫描图像 图1A示谱域光学相干断层扫描整体图像,脉络膜层可见脉络膜高反射灶,蓝色方框标记高反射灶集中区域;图1B示对应区域的放大图像,红色箭头示部分脉络膜高反射灶  图2 Stargardt病患眼谱域光学相干断层扫描图像 图2A示谱域光学相干断层扫描整体图像,脉络膜层可见脉络膜高反射灶,蓝色方框标记高反射灶集中区域;图2B示对应区域的放大图像,红色箭头示部分脉络膜高反射灶
[1]
Hurley JB. Retina metabolism and metabolism in the pigmented epithelium: a busy intersection[J]. Annu Rev Vis Sci, 2021, 7(1): 665-692.
[2]
Weill Y, Brosh K, Levi VT, et al. Enhanced depth imaging in swept-source optical coherence tomography: improving visibility of choroid and sclera, a masked study[J]. Eur J Ophthalmol, 2020, 30(6): 1295-1300.
[3]
Alizadeh ER, Mahdad E, Alireza P, et al. An update on choroidal layer segmentation methods in optical coherence tomography images: a review[J]. J Biomed Phys Eng, 2022, 12(1): 1-20.
[4]
Kim YH, Togloom A, Oh J. Correlation between hyperreflective foci in the choroid and choroidal discoloration in Vogt-Koyanagi-Harada disease[J]. Invest Ophthalmol Vis Sci, 2022, 63(9): 27-35.
[5]
Huang CH, Yang CH, Lai YJ, et al. Hyperreflective foci as important prognostic indicators of progression of retinitis pigmentosa[J]. Retina, 2022, 42(2): 388-395.
[6]
Roy R, Saurabh K, Shah D, et al. Choroidal hyperreflective foci: a novel spectral domain optical coherence tomography biomarker in eyes with diabetic macular edema[J]. Asia Pac J Ophthalmol (Phila), 2019, 8(4): 314-318.
[7]
Chhablani J, Hanumunthadu D, Matet A, et al. Evaluation of choroidal hyperreflective dots in acute and chronic central serous chorioretinopathy[J]. Indian J Ophthalmol, 2019, 67(11): 1850-1855.
[8]
Battaglia PM, Sacconi R, Romano F, et al. Hyperreflective foci in Stargardt disease: 1-year follow-up[J]. Graefes Arch Clin Exp Ophthalmol, 2019, 257(1): 41-48.
[9]
Ulla L, Foti C, Arrigo A, et al. Choroidal hyperreflective foci represent a common finding across different types of macular atrophy[J]. Invest Ophthalmol Vis Sci, 2025, 66(6): 42-48.
[10]
Hsia Y, Yang CH, Hsieh YT, et al. Hyperreflective foci in predicting the treatment outcome of antivascular endothelial growth factor in neovascular age-related macular degeneration[J]. Graefes Arch Clin Exp Ophthalmol, 2020, 258(2): 273-280.
[11]
Midena G, Danieli L, Pilotto E, et al. Hyperreflective choroidal foci in diabetic eyes with and without macular edema: novel insights on diabetic choroidopathy[J]. Exp Eye Res, 2024, 247: 110020.
[12]
Ípek ʂ C, Ayhan Z, Kadayıfçılar S, et al. Swept-source optical coherence tomography angiography in a patient with Bietti crystalline dystrophy followed for ten years[J]. Turk J Ophthalmol, 2019, 49(2): 106-108.
[13]
Kim YH, Oh J. Hyperreflective foci in the choroid of normal eyes[J]. Graefes Arch Clin Exp Ophthalmol, 2022, 260(3): 759-769.
[14]
Song MS, Kim YH, Oh J. Spatial distribution of hyperreflective choroidal foci in the macula of normal eyes[J]. Transl Vis Sci Technol, 2024, 13(8): 35-41.
[15]
Félix R, Gouveia N, Bernardes J, et al. Prognostic impact of hyperreflective foci in nonsyndromic retinitis pigmentosa[J]. Graefes Arch Clin Exp Ophthalmol, 2024, 262(9): 2851-2858.
[16]
Arrigo A, Amato A, Barresi C, et al. Choroidal modifications preceding the onset of macular neovascularization in age-related macular degeneration[J]. Ophthalmol Ther, 2022, 11(1): 377-386.
[17]
Nassisi M, Fan W, Shi Y, et al. Quantity of intraretinal hyperreflective foci in patients with intermediate age-related macular degeneration correlates with 1-year progression[J]. Invest Ophthalmol Vis Sci, 2018, 59(8): 3431-3437.
[18]
Saurabh K, Roy R, Herekar S, et al. Validation of choroidal hyperreflective foci in diabetic macular edema through a retrospective pilot study[J]. Indian J Ophthalmol, 2021, 69(11): 3203-3206.
[19]
Nanji K, Grad J, Hatamnejad A, et al. Baseline optical coherence tomography biomarkers associated with visual acuity in diabetic macular edema: a systematic review and meta-analysis[J]. Ophthalmology, 2025: S016164202500483X.
[20]
Markan A, Agarwal A, Arora A, et al. Novel imaging biomarkers in diabetic retinopathy and diabetic macular edema[J]. Ther Adv Ophthalmol, 2020, 12: 2515841420950513.
[21]
Kang JW, Chung H, Chan KH. Correlation of optical coherence tomographic hyperreflective foci with visual outcomes in different patterns of diabetic macular edema[J]. Retina, 2016, 36(9): 1630-1639.
[22]
Hwang HS, Chae JB, Kim JY, et al. Association between hyperreflective dots on spectral-domain optical coherence tomography in macular edema and response to treatment[J]. Invest Ophthalmol Vis Sci, 2017, 58(13): 5958-5963.
[23]
Schreur V, Altay L, Van AF, et al. Hyperreflective foci on optical coherence tomography associate with treatment outcome for anti-VEGF in patients with diabetic macular edema[J]. PLoS One, 2018, 13(10): e0206482.
[24]
Arrigo A, Capone L, Lattanzio R, et al. Optical coherence tomography biomarkers of inflammation in diabetic macular edema treated by fluocinolone acetonide intravitreal drug-delivery system implant[J]. Ophthalmol Ther, 2020, 9(4): 971-980.
[25]
Kim M, Lee JH, Suh H, et al. Hyperreflective choroidal foci and their longitudinal changes following treatment for branched retinal vein occlusion-associated macular edema[J]. Retina, 2026: 1-24.
[26]
Borrelli E, Reibaldi M, Barresi C, et al. Choroidal hyperreflective foci in geographic atrophy[J]. Invest Ophthalmol Vis Sci, 2023, 64(14): 5-9.
[27]
Arrigo A, Calamuneri A, Aragona E, et al. OCTA-based identification of different vascular patterns in Stargardt disease[J]. Transl Vis Sci Technol, 2019, 8(6): 26-31.
[28]
Lee SY, Yoon CK, Park UC, et al. Choroidal hyperreflective foci as biomarkers of severity in Stargardt disease[J]. Retina, 2025, 45(4): 774-784.
[29]
Arrigo A, Calamuneri A, Aragona E, et al. Structural OCT parameters associated with treatment response and macular neovascularization onset in central serous chorioretinopathy[J]. Ophthalmol Ther, 2021, 10(2): 289-298.
[30]
Hwang BE, Kim JY, Kim RY, et al. En-face optical coherence tomography hyperreflective foci of choriocapillaris in central serous chorioretinopathy[J]. Sci Rep, 2023, 13(1): 7184-7190.
[31]
Jorge RM, Marco P, Matteo G, et al. Choroidal characteristics of acute and chronic central serous chorioretinopathy using enhanced depth imaging optical coherence tomography[J]. Eur J Ophthalmol, 2017, 27(4): 476-480.
[32]
Chhablani J, Hanumunthadu D, Rasheed M, et al. Choroidal hyperreflective foci and vascularity in retinal dystrophy[J]. Indian J Ophthalmol, 2020, 68(1): 130-136.
[33]
何桂琴,文峰。正常眼的脉络膜血管系统研究进展[J]. 眼科学报2024, 39(7):365-373.
[34]
Agrawal R, Arora R, Keane PA, et al. Morphometric features on enhanced depth imaging optical coherence tomography scans in idiopathic posterior uveitis or panuveitis[J]. Int Ophthalmol, 2018, 38(3): 993-1002.
[35]
Cideciyan AV, Aleman TS, Swider M, et al. Mutations in ABCA4 result in accumulation of lipofuscin before slowing of the retinoid cycle: a reappraisal of the human disease sequence[J]. Hum Mol Genet, 2004, 13(5): 525-534.
[36]
Romano F, Arrigo A, MacLaren RE, et al. Hyperreflective foci as a pathogenetic biomarker in choroideremia[J]. Retina, 2020, 40(8): 1634-1640.
[37]
Davis JL. Intraocular lymphoma: a clinical perspective[J]. Eye, 2013, 27(2): 153-162.
[38]
Menean M, Apuzzo A, Mastaglio S, et al. Imaging biomarkers of leukaemic choroidopathy[J]. Acta Ophthalmol, 2023, 101(5): 553-559.
[39]
Silpa-archa S, Silpa-archa N, Preble JM, et al. Vogt-Koyanagi-Harada syndrome: perspectives for immunogenetics, multimodal imaging, and therapeutic options[J]. Autoimmun Rev, 2016, 15(8): 809-819.
[40]
Lima LH, De Andrade GC, Vianello S, et al. Multimodal imaging analyses of hyperreflective dot-like lesions in acute syphilitic posterior placoid chorioretinopathy[J]. J Ophthalmic Inflamm Infect, 2017, 7(1): 1-6.
[41]
Crist AJ. Case report: choriocapillaris flow voids in acute syphilitic posterior placoid chorioretinitis[J]. Ocul Immunol Inflamm, 2022, 99(10): 774-780.
[42]
Pichi F, Ciardella AP, Cunningham ET, et al. Spectral domain optical coherence tomography findings in patients with acute syphilitic posterior placoid chorioretinopathy[J]. Retina, 2014, 34(2): 373-384.
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