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[年龄相关性黄斑变性中玻璃膜疣的眼底自发荧光模式]

[Fundus autofluorescence patterns of drusen in age-related macular degeneration].

作者信息

Xuan Yi, Zhao Pei-quan, Peng Qing

机构信息

Department of Ophthalmology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2010 Aug;46(8):708-13.

Abstract

OBJECTIVE

To investigate the characteristics of fundus autofluorescence (FAF) patterns of drusen in patients with nonexudative age-related macular degeneration (AMD).

METHODS

It was a retrospective case series study. Spatial distribution and intensity of FAF of 63 cases (78 eyes) with nonexudative AMD were recorded using a confocal scanning laser ophthalmoscopy (cSLO, Heidelberg Retina Angiograph 2, HRA2, Heidelberg, Germany), the excitation light used was at 488 nm (argon laser), emission light at 514 nm (barrier filter), and fundus field-of-view at 30-degrees. Color fundus photographs were obtained with Kowa Nonmyd 7. Three-dimensional fundus images were captured by spectral domain optical coherence tomography (Topcon, 3D OCT-1000, Japan).

RESULTS

The FAF changes did not correlate topographically with visible fundus changes and 3D-OCT images in 78 eyes with drusen in nonexudative AMD. The majority of these eyes (68 out of 78) showed abnormal FAF signal of drusen at the posterior pole, which could be classified into seven different patterns according to their different features: minimal, focal confluent, linear, patchy, lace-like, speckled and scattered changes. In the remaining 10 eyes, the small lesions presented in color fundus photos were not detected in FAF examination. Therefore, a homogeneous background signal similar to the normal fundus was obtained by FAF examination. In addition, 15 patients exhibited abnormal autofluorescence in both eyes, 13 of them showed asymmetrical FAF changes, indicating that asymmetrical lesions might be presented.

CONCLUSIONS

Various patterns of abnormal FAF can be clearly imaged with HRA2-cSLO in nonexudative AMD, reflecting different stages of this disease. Periodic observation of drusen with FAF examination is of great clinical value in the estimation of occurrence and development of AMD.

摘要

目的

研究非渗出性年龄相关性黄斑变性(AMD)患者玻璃膜疣的眼底自发荧光(FAF)特征。

方法

这是一项回顾性病例系列研究。使用共焦扫描激光眼底镜(cSLO,德国海德堡视网膜血管造影仪2型,HRA2)记录63例(78只眼)非渗出性AMD患者的FAF空间分布和强度,激发光为488nm(氩激光),发射光为514nm(滤光片),眼底视野为30度。用柯瓦Nonmyd 7获取彩色眼底照片。通过光谱域光学相干断层扫描(日本拓普康3D OCT - 1000)采集三维眼底图像。

结果

在78只患有玻璃膜疣的非渗出性AMD眼中,FAF变化与可见眼底变化及三维光学相干断层扫描(3D - OCT)图像在地形学上不相关。这些眼中的大多数(78只中的68只)在后极部显示玻璃膜疣的异常FAF信号,根据其不同特征可分为七种不同模式:最小、局灶融合、线性、斑片状、蕾丝样、斑点状和散在改变。在其余10只眼中,彩色眼底照片中呈现的小病变在FAF检查中未被检测到。因此,FAF检查获得了与正常眼底相似的均匀背景信号。此外,15例患者双眼出现异常自发荧光,其中13例显示FAF不对称改变,表明可能存在不对称病变。

结论

使用HRA2 - cSLO可在非渗出性AMD中清晰成像各种异常FAF模式,反映该疾病的不同阶段。通过FAF检查定期观察玻璃膜疣对评估AMD的发生和发展具有重要临床价值。

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