Dugel Pravin U, Zimmer Cheryl N, Shahidi Ayda M
Retinal Consultants of Arizona, Phoenix, Arizona, USA.
USC Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Am J Ophthalmol Case Rep. 2016 Apr 14;2:18-22. doi: 10.1016/j.ajoc.2016.04.003. eCollection 2016 Jul.
To report the use of non-invasive multi-spectral imaging of a female choroideremia (CHM) carrier with mild visual symptoms and extensive fundus mottling.
This was an observational case report study. A symptomatic 42-year-old female with a history of binocular CHM presented for routine ocular examination and underwent review of her clinical and photographic records, optical coherence tomography (OCT), intravenous fluorescein angiography (IVFA) and multi-spectral imaging (MSI). Dilated fundus examination and photography revealed similar outcomes of diffuse mottling with normal looking vessels. IVFA showed large irregular and confluent patches of RPE atrophy in the peripapillary and parapapillary areas as well as the midperiphery, corresponding to the OCT findings. The entire range of MSI imaging (520-940 nm) clearly illustrated the anomalies of the fundus including retinal pigment epithelium (RPE) mottling with melanin clumping not readily seen with the other imaging modalities. MSI fundus autofluorescence (MSI-FAF) showed a spotty hypo and hyperautofluorescent appearance of the fundus, consistent with the observations seen on IVFA and OCT images.
MSI significantly improves visualization of the retinal pigment epithelium in choroideremia. The non-invasive nature of MSI technique is a valuable tool in monitoring the effect of retinal and choroidal presentation in patients with CHM.
报告对一名患有轻度视觉症状且眼底有广泛斑纹的女性脉络膜营养不良（CHM）携带者进行非侵入性多光谱成像的应用情况。
这是一项观察性病例报告研究。一名有双眼CHM病史的42岁有症状女性前来进行常规眼科检查，并对其临床和影像记录、光学相干断层扫描（OCT）、静脉荧光素血管造影（IVFA）和多光谱成像（MSI）进行了复查。散瞳眼底检查和摄影显示出类似的弥漫性斑纹结果，血管外观正常。IVFA显示视乳头周围和视乳头旁区域以及中周部有大片不规则且融合的视网膜色素上皮（RPE）萎缩斑，与OCT检查结果相符。整个MSI成像范围（520 - 940纳米）清晰地显示了眼底异常，包括视网膜色素上皮（RPE）斑纹以及黑色素聚集，而其他成像方式不易看到这些情况。MSI眼底自发荧光（MSI-FAF）显示眼底有斑点状低自发荧光和高自发荧光外观，与IVFA和OCT图像上的观察结果一致。
MSI显著改善了脉络膜营养不良中视网膜色素上皮的可视化。MSI技术的非侵入性本质是监测CHM患者视网膜和脉络膜表现效果的宝贵工具。
