Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), The University of Western Australia, Perth, Western Australia, Australia.
Department of Ophthalmology, Royal Perth Hospital, Perth, Western Australia, Australia; and.
Retin Cases Brief Rep. 2020 Summer;14(3):239-242. doi: 10.1097/ICB.0000000000000684.
BACKGROUND/PURPOSE: To report a case of cuticular drusen in an indigenous Australian.
A 37-year-old indigenous (aboriginal) Australian woman from a remote Western Australian town presented with a 2-month history of vision loss. Clinical history, examination, and multimodal retinal imaging data from spectral domain optical coherence tomography, fundus autofluorescence, fluorescein angiography, and indocyanine green angiography were analyzed.
Multimodal imaging confirmed cuticular drusen complicated by a right choroidal neovascularization with pigment epithelial detachment and a left foveal vitelliform lesion. An unusual "negative-staining" pattern was noted on late phase indocyanine green angiography and this spared the regions affected by cuticular drusen.
To the best of our knowledge, this is the first published report of cuticular drusen in an indigenous Australian. We hypothesize that this may be secondary to ancestral mixing of the gene pool. An unusual staining pattern witnessed on indocyanine green angiography suggests widespread disturbance of lipoprotein deposition in the Bruch membrane.
背景/目的:报告一例澳大利亚原住民的角膜小滴状沉积物。
一位来自西澳大利亚偏远城镇的 37 岁原住民(土著)女性因视力丧失 2 个月就诊。对病史、检查和来自频域光学相干断层扫描、眼底自发荧光、荧光素血管造影和吲哚青绿血管造影的多模态视网膜成像数据进行了分析。
多模态成像证实了角膜小滴状沉积物并发右侧脉络膜新生血管伴色素上皮脱离和左侧黄斑部类脂性玻璃膜疣。在吲哚青绿血管造影的晚期相中观察到一种不寻常的“负染”模式,这一模式避开了受角膜小滴状沉积物影响的区域。
据我们所知,这是首例在澳大利亚原住民中报道的角膜小滴状沉积物病例。我们推测这可能是由于基因库的祖先混合所致。在吲哚青绿血管造影上观察到的一种不寻常的染色模式提示广泛的脂蛋白沉积在布鲁赫膜中受到干扰。