红外扫描激光检眼镜视网膜成像在斯特格黄斑营养不良患者中的价值。
The value of retinal imaging with infrared scanning laser ophthalmoscopy in patients with stargardt disease.
作者信息
Chun Robert, Fishman Gerald A, Collison Frederick T, Stone Edwin M, Zernant Jana, Allikmets Rando
机构信息
*Pangere Center for Inherited Retinal Disease, The Chicago Lighthouse For People Who Are Blind or Visually Impaired, Chicago, Illinois; †Department of Ophthalmology, University of Illinois, Chicago, Illinois; ‡Howard Hughes Medical Institute, Chevy Chase, MD; §Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, Iowa; and ¶Department of Ophthalmology, Columbia University, New York, New York.
出版信息
Retina. 2014 Jul;34(7):1391-9. doi: 10.1097/IAE.0000000000000070.
PURPOSE
To demonstrate the value of infrared scanning laser ophthalmoscopy (SLO) for determining structural retinal and choroidal changes in patients with Stargardt disease and its comparison to findings on short-wavelength fundus autofluorescence (SW-AF) imaging, spectral-domain optical coherence tomography, and microperimetry measurements.
METHODS
Forty-four eyes of 22 patients with Stargardt disease were studied using infrared-SLO, spectral-domain optical coherence tomography, macular microperimetry, SW-AF, electroretinography, and fundus photography.
RESULTS
Although SW-AF imaging outlined the regions of retinal pigment epithelial (RPE) atrophy (hypofluorescence) and enhanced the visibility of more funduscopically apparent flecks (hyperfluorescence), infrared-SLO imaging outlined the regions of choroidal, and RPE, atrophic changes. Degenerative changes in photoreceptor and RPE cell layers, evident on spectral-domain optical coherence tomography imaging, were associated with either hyporeflective or hyperreflective images on infrared-SLO imaging, depending on whether both RPE and choroidal atrophy (hyperreflectance) or solely RPE atrophy (hyporeflectance) was present. Threshold elevations on microperimetry testing corresponded to both RPE and choroidal atrophy on infrared-SLO imaging and RPE atrophy on SW-AF.
CONCLUSION
Although SW-AF identifies regions of RPE atrophy, infrared-SLO also identifies the involvement of the choroid that has important implications for the potential improvement in visual function from treatment. Thus, infrared-SLO imaging offers an additional advantage beyond that obtained with SW-AF.
目的
证明红外扫描激光检眼镜（SLO）在确定斯塔加特病患者视网膜和脉络膜结构变化方面的价值，并将其与短波长眼底自发荧光（SW-AF）成像、光谱域光学相干断层扫描和微视野测量结果进行比较。
方法
使用红外SLO、光谱域光学相干断层扫描、黄斑微视野、SW-AF、视网膜电图和眼底摄影对22例斯塔加特病患者的44只眼睛进行研究。
结果
虽然SW-AF成像勾勒出视网膜色素上皮（RPE）萎缩区域（低荧光）并增强了眼底可见的更多斑点（高荧光）的可见性，但红外SLO成像勾勒出脉络膜和RPE萎缩性变化区域。光谱域光学相干断层扫描成像中明显的光感受器和RPE细胞层的退行性变化与红外SLO成像中的低反射或高反射图像相关，这取决于是否同时存在RPE和脉络膜萎缩（高反射）或仅存在RPE萎缩（低反射）。微视野测试中的阈值升高与红外SLO成像中的RPE和脉络膜萎缩以及SW-AF中的RPE萎缩相对应。
结论
虽然SW-AF可识别RPE萎缩区域，但红外SLO还可识别脉络膜受累情况，这对治疗后视觉功能的潜在改善具有重要意义。因此，红外SLO成像提供了超越SW-AF的额外优势。
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