Kitaguchi Yoshiyuki, Fujikado Takashi, Bessho Kenichiro, Sakaguchi Hirokazu, Gomi Fumi, Yamaguchi Tatsuo, Nakazawa Naoki, Mihashi Toshifumi, Tano Yasuo
Department of Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan.
Ophthalmology. 2008 Oct;115(10):1771-7. doi: 10.1016/j.ophtha.2008.03.026. Epub 2008 May 16.
To examine highly localized photoreceptor disruptions in the fovea by a high-resolution adaptive optics (AO) fundus camera combined with Fourier-domain optical coherence tomography (FD OCT).
Observational case series.
Three eyes of 3 patients who showed dark foveal spots by slit-lamp biomicroscopy.
Three patients who reported metamorphopsia but showed no changes in the retina in conventional fundus photographs were examined. High-resolution retinal images were obtained with the AO fundus camera and by FD OCT. The images were compared with the findings obtained by standard clinical tests, including Amsler charts and fluorescein angiography (FA).
Quantitative measurements of the area of photoreceptor disruption.
Slit-lamp biomicroscopy revealed an irregularly shaped dark spot in the fovea centralis but no changes in FA in the 3 cases. The photoreceptor mosaic was absent in a highly localized area of the fovea in the images obtained by the AO fundus camera, and the photoreceptor outer segment was absent or disturbed at the corresponding area by FD OCT in all 3 cases. The horizontal and vertical sizes of the area of disturbance of the photoreceptor mosaic in the AO images in the 3 eyes were 400x200 microm, 300x120 microm, and 300x200 microm. These sizes were comparable to the photoreceptor outer segment disturbances in the OCT images which were 330x150 microm, 280x100 microm, 200x150 microm, respectively.
Localized OS disturbances were able to be detected in eyes with a dark foveal spot by AO fundus camera 2-dimensionally and by FD OCT axially. The good correspondence of the sizes of the area of photoreceptor disturbances obtained by AO images to those by FD OCT images indicate that the AO images can be used to evaluate and follow the 2-dimensional area of focal changes of the photoreceptors in the fovea quantitatively.
通过高分辨率自适应光学（AO）眼底相机结合傅里叶域光学相干断层扫描（FD OCT）检查黄斑区高度局限性的光感受器破坏情况。
观察性病例系列。
3例患者的3只眼，裂隙灯生物显微镜检查显示黄斑区有暗斑。
对3例主诉视物变形但常规眼底照片显示视网膜无变化的患者进行检查。使用AO眼底相机和FD OCT获取高分辨率视网膜图像。将这些图像与包括Amsler表和荧光素血管造影（FA）在内的标准临床检查结果进行比较。
光感受器破坏区域的面积定量测量。
裂隙灯生物显微镜检查显示3例患者黄斑中心凹有不规则形状的暗斑，但FA无变化。AO眼底相机获取的图像显示黄斑区高度局限性区域的光感受器镶嵌缺失，FD OCT显示所有3例患者相应区域的光感受器外段缺失或紊乱。3只眼中AO图像上光感受器镶嵌破坏区域的水平和垂直尺寸分别为400×200微米、300×120微米和300×200微米。这些尺寸与OCT图像上光感受器外段紊乱区域的尺寸相当，分别为330×150微米、280×100微米、200×150微米。
通过AO眼底相机二维成像和FD OCT轴向成像能够检测出黄斑区有暗斑的眼中存在局限性的光感受器外段紊乱。AO图像上光感受器破坏区域的尺寸与FD OCT图像上的尺寸具有良好的对应性，表明AO图像可用于定量评估和随访黄斑区光感受器局灶性变化的二维区域。
