Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris XII, Creteil, France.
Retina. 2011 Mar;31(3):518-26. doi: 10.1097/IAE.0b013e3181f04974.
The purpose of this study was to analyze the integrated infrared reflectance, fundus autofluorescence, and fluorescein angiography (integrated confocal scanning laser ophthalmoscopy fundus imaging) features of reticular pseudodrusen and eye-tracked Spectralis high-resolution spectral domain optical coherence tomography (Spectralis SD-OCT; Heidelberg Engineering, Heidelberg, Germany).
Twenty-two consecutive patients with reticular pseudodrusen were prospectively enrolled and evaluated regarding confocal scanning laser ophthalmoscopy fundus imaging and eye-tracked SD-OCT findings.
Integrated fundus imaging revealed a "target" aspect of most reticular pseudodrusen in the 42 included eyes (22 patients; 12 women, 10 men; mean age 81.38 ± 6.47 years). On fundus autofluorescence and infrared reflectance, the center of most reticular pseudodrusen appeared as an area of isoautofluorescence/reflectance surrounded by halos of reduced autofluorescence/reflectance. Similarly, on fluorescein angiography, the center of reticular pseudodrusen appeared as an area of decreased fluorescence surrounded by a faint halo of increased fluorescence. Spectral domain optical coherence tomography showed a well-defined round or triangular hyperreflective deposit localized between, externally, the retinal pigment epithelium layer, and, internally, the external limiting membrane or the outer plexiform layer. Moreover, SD-OCT showed the loss of both outer segment/retinal pigment epithelium interface and inner segment/outer segment interface over the hyperreflective lesions, as well as an abrupt interruption of both these interfaces at the border of the hyperreflective lesions.
The peculiar confocal scanning laser ophthalmoscopy fundus imaging and tracked SD-OCT of reticular pseudodrusen suggest the presence of central lipofuscin-like retinal deposits localized above the retinal pigment epithelium. These findings give insights to other possible aspects of age-related retinal changes.
本研究旨在分析网状假性drusen 的整合型红外反射率、眼底自发荧光和荧光素血管造影（整合型共焦扫描激光检眼镜眼底成像）特征，并结合 Spectralis 高分辨率频域光学相干断层扫描（Spectralis SD-OCT；德国海德堡工程公司）进行眼部追踪。
前瞻性纳入 22 例连续的网状假性drusen 患者，评估其共焦扫描激光检眼镜眼底成像和眼部追踪 SD-OCT 结果。
整合型眼底成像在 42 只纳入眼中（22 例患者；12 名女性，10 名男性；平均年龄 81.38±6.47 岁）发现多数网状假性drusen 呈现“靶样”外观。在眼底自发荧光和红外反射率上，大多数网状假性drusen 的中心呈现为等自发荧光/反射率区域，周围环绕着自发荧光/反射率降低的晕环。类似地，在荧光素血管造影上，网状假性drusen 的中心呈现为荧光减弱的区域，周围环绕着荧光增强的微弱晕环。频域光学相干断层扫描显示，在视网膜色素上皮层外部和外部限膜或外丛状层内部之间，存在一个界限清晰的圆形或三角形高反射性沉积物。此外，SD-OCT 显示在高反射性病变上方，外节/视网膜色素上皮界面和内节/外节界面均丢失，并且在高反射性病变边界处，这两个界面突然中断。
网状假性drusen 的特殊共焦扫描激光检眼镜眼底成像和追踪 SD-OCT 提示存在位于视网膜色素上皮上方的中央脂褐素样视网膜沉积物。这些发现为与年龄相关的视网膜变化的其他可能方面提供了深入了解。
