Lavinsky Daniel, Belfort Rubens N, Navajas Eduardo, Torres Virginia, Martins Maria Cristina, Belfort Rubens
Vision Institute, Escola Paulista de Medicina, Universidade Federal de São Paulo, SP 04023-062, Brazil.
Br J Ophthalmol. 2007 Oct;91(10):1299-302. doi: 10.1136/bjo.2007.116665. Epub 2007 Apr 12.
To describe autofluorescence patterns of choroidal melanocytic lesions using the Heidelberg Retinal Angiograph 2 system (HRA2).
20 patients with choroidal melanocytic lesions in the ocular fundus underwent ophthalmologic examination, fundus photography, autofluorescence and optical coherence tomography (OCT). Pathologic examination was performed on one enucleated eye with a large choroidal melanoma.
15 patients had choroidal nevi and 5 had malignant choroidal melanoma (1 small, 1 medium and 3 large tumours). Choroidal nevi did not show any characteristic autofluorescence pattern, although secondary retinal pigment epithelium (RPE) changes, such as drusen and pigment epithelium detachment, appeared faintly hyperautofluorescent in 2 patients. Only the small malignant choroidal melanomas had prominent orange pigmentation, although all melanomas had an intense confluent hyperautofluorescent signal over the lesions. Pathology of one large malignant melanoma revealed lipofuscin underlying RPE.
Most nevi did not have characteristic hyperautofluorescent features, but choroidal melanomas seemed to have a pattern of confluent hyperautofluorescence. Therefore, autofluorescence may be a useful non-invasive tool to assess lipofuscin in pigmented choroidal lesions, which may contribute to the diagnosis of malignancy. This hypothesis, however, remains to be confirmed in large prospective studies.
使用海德堡视网膜血管造影仪2系统（HRA2）描述脉络膜黑素细胞性病变的自发荧光模式。
20例患有眼底脉络膜黑素细胞性病变的患者接受了眼科检查、眼底照相、自发荧光和光学相干断层扫描（OCT）。对1只摘除的患有大脉络膜黑色素瘤的眼睛进行了病理检查。
15例患者患有脉络膜痣，5例患有恶性脉络膜黑色素瘤（1例小肿瘤、1例中等大小肿瘤和3例大肿瘤）。脉络膜痣未显示任何特征性的自发荧光模式，尽管2例患者出现了继发性视网膜色素上皮（RPE）改变，如玻璃膜疣和色素上皮脱离，表现为轻度高自发荧光。只有小的恶性脉络膜黑色素瘤有明显的橙色色素沉着，尽管所有黑色素瘤在病变部位都有强烈的融合性高自发荧光信号。1例大的恶性黑色素瘤的病理显示RPE下有脂褐素。
大多数痣没有特征性的高自发荧光特征，但脉络膜黑色素瘤似乎有融合性高自发荧光模式。因此，自发荧光可能是评估色素性脉络膜病变中脂褐素的一种有用的非侵入性工具，这可能有助于恶性肿瘤的诊断。然而，这一假设仍有待大型前瞻性研究证实。
