Gili Pablo, Flores-Rodríguez Patricia, Yangüela Julio, Herreros Fernández María Luisa
Ophthalmology Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain; Health Sciences Faculty, Universidad Europea, Madrid, Spain.
J AAPOS. 2013 Dec;17(6):568-71. doi: 10.1016/j.jaapos.2013.07.012. Epub 2013 Nov 7.
To assess the efficacy of using autofluorescence to identify optic nerve head drusen (ONHD) in children.
We conducted a cross-sectional, descriptive study of subjects <18 years of age with possible pseudopapilledema due to ONHD. B-scan ultrasonography was considered the gold standard diagnostic technique. All participants underwent an extensive ophthalmic examination that included fundus color photography, autofluorescence analysis, and B-scan echography. ONHD were classified as visible or hidden. Autofluorescence images were analyzed by three observers who were masked to the results of B-scan ultrasonography.
A total of 24 children with pseudopapilledema were included. B-scan ultrasonography confirmed ONHD in 32 eyes of 18 patients (9 boys). Mean patient age was 12 years (range, 7-17 years). ONHD was bilateral in 14 patients; unilateral in 4. The majority of the drusen were hidden (26 of 32 eyes). Analysis of autofluorescence patterns identified the drusen in 94% of cases (30 of 32 eyes): visible, 100%; hidden, 92%. Interobserver agreement was high (κ = 0.91, κ = 0.96, κ = 0.89).
In this study cohort, autofluorescence proved a safe, fast, and reliable technique for identifying ONHD in children.
评估利用自发荧光识别儿童视神经乳头 drusen（ONHD）的有效性。
我们对年龄小于 18 岁、因 ONHD 可能出现假性视乳头水肿的受试者进行了一项横断面描述性研究。B 超检查被视为金标准诊断技术。所有参与者均接受了全面的眼科检查，包括眼底彩色照相、自发荧光分析和 B 超检查。ONHD 被分为可见性或隐匿性。由三名对 B 超检查结果不知情的观察者对自发荧光图像进行分析。
共纳入 24 例假性视乳头水肿患儿。B 超检查证实 18 例患者（9 名男孩）的 32 只眼中存在 ONHD。患者平均年龄为 12 岁（范围 7 - 17 岁）。14 例患者为双侧 ONHD；4 例为单侧。大多数 drusen 为隐匿性（32 只眼中的 26 只）。自发荧光模式分析在 94%的病例（32 只眼中的 30 只）中识别出了 drusen：可见性 drusen，识别率为 100%；隐匿性 drusen，识别率为 92%。观察者间一致性较高（κ = 0.91，κ = 0.96，κ = 0.89）。
在本研究队列中，自发荧光被证明是一种安全、快速且可靠的识别儿童 ONHD 的技术。
