Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Medical Center, New York, New York 10032, USA.
Retina. 2010 Jul-Aug;30(7):1095-103. doi: 10.1097/IAE.0b013e3181cd48f9.
The purpose of this study was to describe fundus autofluorescence (FAF), optical coherence tomography, and electroretinogram findings in choroidal sclerosis.
This is a retrospective case series. Eight eyes of four patients with choroidal sclerosis were evaluated with FAF, optical coherence tomography, and electroretinogram testing.
In all eight eyes, FAF imaging showed hypofluorescent placoid lesions corresponding to areas of chorioretinal atrophy seen on stereo biomicroscopy. Prominent hyperfluorescent linear markings underlying regions of atrophic disease were observed in all eyes, likely representative of normal choroidal vessel autofluorescence. In two eyes, FAF showed punctate hypofluorescent lesions in the fovea that were not visualized on biomicroscopy. In one eye, FAF identified a central island of preserved retinal pigment epithelium that was not realized on ophthalmoscopic examination. Optical coherence imaging was significant for loss of choroidal fine tubular structures, retinal pigment epithelium, and outer nuclear layer in regions of chorioretinal atrophy. Full-field electroretinogram testing showed generalized rod-cone dysfunction in all patients with a lower B- to A-wave ratio in two patients.
Fundus autofluorescence and optical coherence tomography are nonin-vasive diagnostic adjuncts that can aid in the diagnosis of choroidal sclerosis. Fundus autofluorescence may be a more sensitive marker of disease extent and progression than clinical examination alone. Electroretinogram testing can result in an electronegative maximal response.
本研究旨在描述脉络膜硬化症的眼底自发荧光(FAF)、光学相干断层扫描和视网膜电图检查结果。
这是一项回顾性病例系列研究。对 4 名脉络膜硬化症患者的 8 只眼进行 FAF、光学相干断层扫描和视网膜电图检查。
在所有 8 只眼中,FAF 成像显示与立体生物显微镜下所见的脉络膜视网膜萎缩相对应的低荧光盘状病变。在所有眼中都观察到在萎缩病变区域下明显的高荧光线性标记,可能代表正常脉络膜血管自发荧光。在 2 只眼中,FAF 在黄斑区显示出点状低荧光病变,在生物显微镜下无法观察到。在 1 只眼中,FAF 识别出在眼底检查中未发现的中央视网膜色素上皮岛。光学相干断层成像显示在脉络膜视网膜萎缩区域中脉络膜精细管状结构、视网膜色素上皮和外核层丧失。全视野视网膜电图检查显示所有患者均存在普遍的杆状和锥状功能障碍,在 2 例患者中 B 波到 A 波的比值较低。
眼底自发荧光和光学相干断层扫描是无创性诊断辅助手段,可辅助诊断脉络膜硬化症。与单纯临床检查相比,眼底自发荧光可能是一种更敏感的疾病程度和进展的标志物。视网膜电图检查可导致负性最大反应。