Fine Howard F, Cunningham Emmett T, Kim Esther, Smith R Theodore, Chang Stanley
From the *Department of Ophthalmology, Columbia University College of Physicians and Surgeons, New York, New York; and the †Department of Ophthalmology, Stanford University School of Medicine, Stanford, and Department of Ophthalmology, California Pacific Medical Center, San Francisco, California.
Retin Cases Brief Rep. 2009 Spring;3(2):137-9. doi: 10.1097/ICB.0b013e3181679f91.
Chorioretinal folds typically involve the choroid, Bruch membrane, retinal pigment epithelium (RPE), and sometimes overlying neurosensory retina. von Winning hypothesized that the alternate banding pattern of choroidal folds shown by fluorescein angiography is explained by RPE density. To our knowledge, autofluorescence imaging of chorioretinal folds has not been previously described.
Case report.
A 47-year-old healthy hyperopic man had best-corrected visual acuity of 20/30 in the right eye and 20/25 in the left eye. Posterior segment examination revealed bilateral chorioretinal folds with subtle streaks of RPE hyperpigmentation and hypopigmentation emanating from both optic nerve heads.
Early-phase fluorescein angiography revealed the characteristic pattern of alternating light and dark bands. Autofluorescence imaging disclosed a similar pattern as well as peripapillary mottling. The alternating patterns of light and dark bands observed using autofluorescence imaging and fluorescein angiography were found to be precisely in register but inverted.
Autofluorescence imaging noninvasively demonstrates the pathognomonic pattern of alternating light and dark bands shown by fluorescein angiography diagnostic of choroidal folds but in an inverse fashion. This observation provides independent support of von Winning's hypothesis regarding the etiopathogenesis of the banding pattern.
脉络膜视网膜皱褶通常累及脉络膜、布鲁赫膜、视网膜色素上皮（RPE），有时还累及上方的神经感觉视网膜。冯·温宁提出，荧光素血管造影显示的脉络膜皱褶交替带状模式可由RPE密度来解释。据我们所知，此前尚未描述过脉络膜视网膜皱褶的自发荧光成像。
病例报告。
一名47岁健康远视男性，右眼最佳矫正视力为20/30，左眼为20/25。眼部后段检查发现双侧脉络膜视网膜皱褶，从两个视盘发出细微的RPE色素沉着过多和色素沉着过少条纹。
早期荧光素血管造影显示出特征性的明暗带交替模式。自发荧光成像也显示出类似模式以及视乳头周围的斑驳。发现使用自发荧光成像和荧光素血管造影观察到的明暗带交替模式精确对齐但相反。
自发荧光成像以非侵入性方式显示了荧光素血管造影诊断脉络膜皱褶时呈现的特征性明暗带交替模式，但方式相反。这一观察结果为冯·温宁关于带状模式发病机制的假说提供了独立支持。
