Lee Cecilia S, Lee Aaron Y, Forooghian Farzin, Bergstrom Chris S, Yan Jiong, Yeh Steven
Section of Vitreoretinal Disease and Surgery, Department of Ophthalmology, Emory Eye Center, Emory University, Atlanta, GA, USA.
Department of Ophthalmology and Visual Sciences, Washington University in St Louis, St Louis, MO, USA.
Clin Ophthalmol. 2014 Sep 29;8:2001-12. doi: 10.2147/OPTH.S68446. eCollection 2014.
To describe the fundus autofluorescence (FAF) features of the inflammatory maculopathies and develop a quantification method for FAF analysis.
This is a retrospective, consecutive case series of patients with inflammatory maculopathies from two tertiary centers. The clinical findings, demographics, and FAF imaging characteristics were reviewed. Foveal autofluorescence (AF) was analyzed. Median and standard deviation (SD) of foveal AF intensity were measured.
Thirty eyes of 15 patients were evaluated with both qualitative and quantitative FAF analysis. In acute macular neuroretinopathy, the active phase showed foveal hypoautofluorescence, which became hypoautofluorescent with resolution. In acute posterior multifocal placoid pigment epitheliopathy, multiple lesions with hypoautofluorescent centers with hyperautofluorescent borders were observed in active disease and became hypoautofluorescent with disease convalescence. In multifocal choroiditis and punctate inner choroiditis, the active hyperautofluorescent lesions progressed to inactive, hypoautofluorescent scars. Active serpiginous choroiditis showed hyperautofluorescent borders adjacent to a helicoid-shaped, hypoautofluorescent scar. Active unilateral acute idiopathic maculopathy (UAIM) showed a complex pattern of hypo- and hyperautoflourescence in the macula. The median foveal AF was the greatest in acute macular neuroretinopathy and UAIM among the maculopathies, while the greatest SD of foveal AF intensity was observed in UAIM.
The active phase of the majority of inflammatory maculopathies was characterized by hyperautofluorescent lesions. Increased SD of foveal AF correlated with a mixture of hypo-and hyperautoflourescence. Median and SD may be useful metrics in foveal AF and quantifiable values that may be assessed over time as a disease process evolves. Improvements in quantification methods of FAF imaging may allow us to objectively evaluate posterior uveitis.
描述炎症性黄斑病变的眼底自发荧光（FAF）特征，并开发一种用于FAF分析的量化方法。
这是一个来自两个三级中心的炎症性黄斑病变患者的回顾性连续病例系列。回顾了临床发现、人口统计学资料和FAF成像特征。分析了中心凹自发荧光（AF）。测量了中心凹AF强度的中位数和标准差（SD）。
对15例患者的30只眼进行了定性和定量FAF分析。在急性黄斑神经视网膜病变中，活动期表现为中心凹低自发荧光，随着病情缓解变为低自发荧光。在急性后极部多灶性扁平色素上皮病变中，活动期可见多个中心低自发荧光、边界高自发荧光的病变，随着病情恢复变为低自发荧光。在多灶性脉络膜炎和点状内层脉络膜炎中，活动期的高自发荧光病变进展为非活动期的低自发荧光瘢痕。活动期匐行性脉络膜炎表现为与螺旋状低自发荧光瘢痕相邻的高自发荧光边界。活动期单侧急性特发性黄斑病变（UAIM）在黄斑区表现为低自发荧光和高自发荧光的复杂模式。在黄斑病变中，急性黄斑神经视网膜病变和UAIM的中心凹AF中位数最大，而UAIM的中心凹AF强度标准差最大。
大多数炎症性黄斑病变的活动期以高自发荧光病变为特征。中心凹AF标准差增加与低自发荧光和高自发荧光的混合有关。中位数和标准差可能是中心凹AF的有用指标以及可量化的值，随着疾病进程的发展可随时间进行评估。FAF成像量化方法的改进可能使我们能够客观地评估后葡萄膜炎。
