Gelman Rony, Chen Royce, Blonska Anna, Barile Gaetano, Sparrow Janet R
Department of Ophthalmology, Columbia University, New York, New York.
Retin Cases Brief Rep. 2012 Fall;6(4):345-8. doi: 10.1097/ICB.0b013e318260af5d.
To evaluate the findings in a case of acute macular neuroretinopathy involving sudden development of scotomas accompanied by rapid focal increases in fundus autofluorescence.
The clinical presentation of the patient was documented by color fundus photographs, fundus autofluorescence, infrared imaging, and high-resolution spectral domain optical coherence tomography. The scotomas were assessed by Humphrey visual field 10-2 and MP-1 microperimetry.
Visual field defects exhibited spatial correspondence with wedge-shaped lesions demonstrable in color fundus photographs and infrared imaging. It was notable that the lesions exhibited increased intensity on autofluorescence images obtained within 3 weeks of presentation. Optical coherence tomography revealed focal loss of photoreceptor inner segment/outer segment junctions in both eyes.
This case was distinguished by the relative rapidity with which the lesions became hyperautofluorescent in fundus autofluorescence images. Given that the bisretinoids that are the source of autofluorescence form in photoreceptor cells and are transferred to retinal pigment epithelium secondarily, the rapid increase in autofluorescence is unlikely to only reflect retinal pigment epithelium status and is more likely to be indicative of photoreceptor cell dysfunctioning and loss of structural integrity.
评估一例急性黄斑神经视网膜病变的检查结果，该病变表现为突然出现暗点，并伴有眼底自发荧光快速局灶性增强。
通过彩色眼底照片、眼底自发荧光、红外成像和高分辨率光谱域光学相干断层扫描记录患者的临床表现。通过 Humphrey 视野 10 - 2 和 MP - 1 微视野计评估暗点。
视野缺损与彩色眼底照片和红外成像中可见的楔形病变在空间上相对应。值得注意的是，在就诊后 3 周内获得的自发荧光图像上，病变的强度增加。光学相干断层扫描显示双眼光感受器内段/外段连接部局灶性缺失。
该病例的特点是病变在眼底自发荧光图像中较快出现高自发荧光。鉴于作为自发荧光来源的双视黄醛在光感受器细胞中形成并随后转移至视网膜色素上皮，自发荧光的快速增加不太可能仅反映视网膜色素上皮的状态，而更可能表明光感受器细胞功能障碍和结构完整性丧失。
