Paavo Maarjaliis, Lee Winston, Merriam John, Bearelly Srilaxmi, Tsang Stephen, Chang Stanley, Sparrow Janet R
Department of Ophthalmology, Columbia University Medical Center, New York, New York, United States.
Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York, United States.
Invest Ophthalmol Vis Sci. 2017 Sep 1;58(11):4769-4777. doi: 10.1167/iovs.17-22338.
We sought to determine whether information revealed from the reflectance, autofluorescence, and absorption properties of RPE cells situated posterior to reticular pseudodrusen (RPD) could provide insight into the origins and structure of RPD.
RPD were studied qualitatively by near-infrared fundus autofluorescence (NIR-AF), short-wavelength fundus autofluorescence (SW-AF), and infrared reflectance (IR-R) images, and the presentation was compared to horizontal and en face spectral domain optical coherence tomographic (SD-OCT) images. Images were acquired from 23 patients (39 eyes) diagnosed with RPD (mean age 80.7 ± 7.1 [SD]; 16 female; 4 Hispanics, 19 non-Hispanic whites).
In SW-AF, NIR-AF, and IR-R images, fundus RPD were recognized as interlacing networks of small scale variations in IR-R and fluorescence (SW-AF, NIR-AF) intensities. Darkened foci of RPD colocalized in SW-AF and NIR-AF images, and in SD-OCT images corresponded to disturbances of the interdigitation (IZ) and ellipsoid (EZ) zones and to more pronounced hyperreflective lesions traversing photoreceptor-attributable bands in SD-OCT images. Qualitative assessment of the outer nuclear layer (ONL) revealed thinning as RPD extended radially from the outer to inner retina. In en face OCT, hyperreflective areas in the EZ band correlated topographically with hyporeflective foci at the level of the RPE.
The hyperreflective lesions corresponding to RPD in SD-OCT scans are likely indicative of degenerating photoreceptor cells. The darkened foci at positions of RPD in NIR-AF and en face OCT images indicate changes in the RPE monolayer with the reduced NIR-AF and en face OCT signal suggesting a reduction in melanin that could be accounted for by RPE thinning.
我们试图确定从位于网状假性玻璃膜疣（RPD）后方的视网膜色素上皮（RPE）细胞的反射率、自发荧光和吸收特性中获得的信息是否能为RPD的起源和结构提供见解。
通过近红外眼底自发荧光（NIR-AF）、短波眼底自发荧光（SW-AF）和红外反射（IR-R）图像对RPD进行定性研究，并将其表现与水平和正面光谱域光学相干断层扫描（SD-OCT）图像进行比较。图像采集自23例（39只眼）诊断为RPD的患者（平均年龄80.7±7.1[标准差]；16名女性；4名西班牙裔，19名非西班牙裔白人）。
在SW-AF、NIR-AF和IR-R图像中，眼底RPD被识别为IR-R和荧光（SW-AF、NIR-AF）强度的小规模变化的交错网络。RPD的暗点在SW-AF和NIR-AF图像中位置重合，在SD-OCT图像中对应于指状交叉（IZ）和椭圆体（EZ）带的紊乱，以及SD-OCT图像中穿过光感受器相关带的更明显的高反射性病变。对外核层（ONL）的定性评估显示，随着RPD从视网膜外层向内层径向扩展，ONL变薄。在正面OCT中，EZ带中的高反射区域在地形上与RPE水平的低反射点相关。
SD-OCT扫描中与RPD对应的高反射性病变可能表明光感受器细胞正在退化。NIR-AF和正面OCT图像中RPD位置的暗点表明RPE单层的变化，NIR-AF和正面OCT信号的降低表明黑色素减少，这可能是由于RPE变薄所致。
