Heiferman Michael J, Fawzi Amani A
Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Retina. 2016 Dec;36 Suppl 1(Suppl 1):S137-S146. doi: 10.1097/IAE.0000000000001254.
To identify the origin and significance of discordance between blue-light autofluorescence (BL-AF; 488 nm) and near-infrared autofluorescence (NI-AF; 787 nm) in patients with age-related macular degeneration (AMD).
A total of 86 eyes of 59 patients with a diagnosis of AMD were included in this cross-sectional study conducted between March 9, 2015 and May 1, 2015. A masked observer examined the BL-AF, NI-AF, and spectral-domain optical coherence tomography images. Areas with discordance of autofluorescence patterns between NI-AF and BL-AF images were correlated with structural findings at the corresponding location in optical coherence tomography scans.
Seventy-nine eyes had discordance between BL-AF and NI-AF. The most common optical coherence tomography finding accounting for these discrepancies was pigment migration accounting for 35 lesions in 21 eyes. The most clinically relevant finding was geographic atrophy missed on BL-AF in 7 eyes.
Our findings indicate that variations in the distribution of lipofuscin, melanin and melanolipofuscin account for the majority of discordance between BL-AF and NI-AF. Given our finding of missed geographic atrophy lesions on BL-AF in 24% of eyes with geographic atrophy (7/29 eyes), clinicians should consider multimodal imaging, including NI-AF and optical coherence tomography, especially in clinical trials of geographic atrophy.
确定年龄相关性黄斑变性（AMD）患者蓝光自发荧光（BL-AF；488nm）与近红外自发荧光（NI-AF；787nm）不一致的来源及意义。
本横断面研究纳入了2015年3月9日至2015年5月1日期间诊断为AMD的59例患者的86只眼。一名经过遮蔽的观察者检查了BL-AF、NI-AF和光谱域光学相干断层扫描图像。NI-AF和BL-AF图像之间自发荧光模式不一致的区域与光学相干断层扫描相应位置的结构发现相关联。
79只眼的BL-AF和NI-AF之间存在不一致。导致这些差异的最常见光学相干断层扫描发现是色素迁移，21只眼中有35个病灶。最具临床相关性的发现是7只眼中BL-AF遗漏了地图样萎缩。
我们的研究结果表明，脂褐素、黑色素和黑素脂褐素分布的变化是BL-AF和NI-AF之间大部分不一致的原因。鉴于我们发现在24%的地图样萎缩眼中（7/29只眼）BL-AF遗漏了地图样萎缩病灶，临床医生应考虑多模态成像，包括NI-AF和光学相干断层扫描，尤其是在地图样萎缩的临床试验中。
