多灶性易消散性白点综合征的扩展临床谱与多模态成像
EXPANDED CLINICAL SPECTRUM OF MULTIPLE EVANESCENT WHITE DOT SYNDROME WITH MULTIMODAL IMAGING.
作者信息
Marsiglia Marcela, Gallego-Pinazo Roberto, Cunha de Souza Eduardo, Munk Marion R, Yu Suquin, Mrejen Sarah, Cunningham Emmett T, Lujan Brandon J, Goldberg Naomi R, Albini Thomas A, Gaudric Alain, Francais Catherine, Rosen Richard B, Freund K Bailey, Jampol Lee M, Yannuzzi Lawrence A
机构信息
*Vitreous-Retina-Macula Consultants of New York and the LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Institute, New York, New York; †Department of Ophthalmology, Columbia University, New York, New York; ‡Department of Ophthalmology, University and Polytechnic Hospital La Fe, Valencia, Spain; §Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, Brazil; ¶Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; **Department of Ophthalmology, Inselspital, University Hospital Bern, Bern, Switzerland; ††Department of Ophthalmology, Shanghai Jiao Tong University Affiliated First People's Hospital, Shanghai, China; ‡‡Quinze-Vingts Hospital, DHU ViewMaintain, Paris, France; §§Department of Ophthalmology, California Pacific Medical Center, San Francisco, California; ¶¶West Coast Retina Medical Group, San Francisco, California; ***Department of Ophthalmology, The Icahn School of Medicine at Mount Sinai, New York, New York; †††Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida; ‡‡‡Hospital Lariboisiere, University Paris, Paris, France; §§§Centre Ophtalmologique de l'Odeon, Paris, France; ¶¶¶Department of Ophthalmology, The New York Eye and Ear Infirmary, New York, New York; and ****Department of Ophthalmology, New York University, New York, New York.
出版信息
Retina. 2016 Jan;36(1):64-74. doi: 10.1097/IAE.0000000000000685.
PURPOSE
To evaluate and characterize multiple evanescent white dot syndrome abnormalities with modern multimodal imaging modalities.
METHODS
This retrospective cohort study evaluated fundus photography, fluorescein angiography, indocyanine green angiography, optical coherence tomography, enhanced depth imaging optical coherence tomography, short-wavelength autofluorescence, and near-infrared autofluorescence.
RESULTS
Thirty-four multiple evanescent white dot syndrome patients with mean age of 28.7 years were studied (range, 14-49 years). Twenty-six patients were women, and eight were men. Initial mean visual acuity was 0.41 logMAR. Final mean visual acuity was 0.03 logMAR. Fluorescein angiography shows a variable number of mid retinal early fluorescent dots distributed in a wreathlike pattern, which correlate to fundus photography, fundus autofluorescence, and indocyanine green angiography. Indocyanine green angiography imaging shows the dots and also hypofluorescent, deeper, and larger spots, which are occasionally confluent, demonstrating a large plaque of deep retinal hypofluorescence. Optical coherence tomography imaging shows multifocal debris centered at and around the ellipsoid layer, corresponding to the location of spots seen with photography, indocyanine green angiography, and fluorescein angiography. Protrusions of the hyperreflectant material from the ellipsoid layer toward the outer nuclear layer correspond to the location of dots seen with photography, indocyanine green angiography, and fluorescein angiography.
CONCLUSION
Multimodal imaging analysis of the retina in patients with multiple evanescent white dot syndrome shows additional features that may help in the diagnosis of the disease and in further understanding its etiology. Multiple evanescent white dot syndrome is predominantly a disease of the outer retina, centered at the ellipsoid zone, but also involving the interdigitation zone and the outer nuclear layer.
目的
运用现代多模态成像技术评估和描述多发性易消散性白点综合征的异常表现。
方法
这项回顾性队列研究评估了眼底照相、荧光素血管造影、吲哚菁绿血管造影、光学相干断层扫描、增强深度成像光学相干断层扫描、短波自发荧光和近红外自发荧光。
结果
研究了34例多发性易消散性白点综合征患者，平均年龄28.7岁（范围14 - 49岁）。其中26例为女性，8例为男性。初始平均视力为0.41 logMAR。最终平均视力为0.03 logMAR。荧光素血管造影显示视网膜中层有数量不等的早期荧光点，呈花环样分布，与眼底照相、眼底自发荧光和吲哚菁绿血管造影相关。吲哚菁绿血管造影成像显示这些荧光点以及低荧光、更深且更大的斑点，这些斑点偶尔融合，呈现出一大片深层视网膜低荧光斑。光学相干断层扫描成像显示多灶性碎片集中在椭圆体层及其周围，与眼底照相、吲哚菁绿血管造影和荧光素血管造影所见斑点的位置相对应。高反射物质从椭圆体层向外核层的突出对应于眼底照相、吲哚菁绿血管造影和荧光素血管造影所见斑点的位置。
结论
对多发性易消散性白点综合征患者视网膜的多模态成像分析显示了有助于该疾病诊断及进一步理解其病因的额外特征。多发性易消散性白点综合征主要是一种外层视网膜疾病，以椭圆体区为中心，但也累及指状交叉区和外核层。
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