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一名中国女性鱼雷状黄斑病变的多模态成像:病例报告

Multimodal imaging of torpedo maculopathy in a Chinese woman: a case report.

作者信息

Ding Yuhua, Yao Bangtao, Ye Hui, Yu Yan

机构信息

Department of Ophthalmology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.

Department of Ophthalmology, Lishui District People's Hospital, Nanjing, Jiangsu Province, China.

出版信息

BMC Ophthalmol. 2019 Jul 19;19(1):154. doi: 10.1186/s12886-019-1161-7.

Abstract

BACKGROUND

Torpedo maculopathy is a rare, benign, and congenital macular lesion that typically appears in a 'torpedo-shape' and is located at the temporal macula region. This study aimed to describe in detail regarding torpedo maculopathy in a Chinese woman using multimodal imaging.

CASE PRESENTATION

A 30-year-old Chinese woman with occasional yellowish-white macular lesions in her right eye during a routine examination was presented to our hospital. She had no other symptoms, and the best-corrected visual acuity of both eyes was 6/6. Funduscopic examination revealed a torpedo-shaped and mild hypopigmented lesion in the temporal macular area of her right eye. Infrared fundal (IR) images showed visible lesion contour, transverse elliptical, and with a tip pointing towards the central fovea of the macula. Microperimetry visual field appeared normal. The spectral-domain optical coherence tomography (SD-OCT) showed a normal inner retina, with mild thinner outer retina and retinal pigment epithelium in the temporal macular area, and correspondingly increased choroidal reflectivity. Other OCT findings included outer retinal loss/attenuation with significant atrophy of an intact ellipsoid zone. OCT angiography (OCTA) of choroid capillary layer revealed increased density of choroidal vasculature in corresponding to the area of the lesion, while the superficial and deep layers revealed normal vasculature. Fundus autofluorescence (FAF) revealed normal signal with slight hyperautofluorescence at the nasal lesion margin. Fundus fluorescence angiography (FFA) of the lesion showed variegated fluorescence and no leakage and change in the morphology during the whole imaging process.

CONCLUSIONS

This is the first report to include a thorough and detailed description of torpedo maculopathy by using fundal photograph, IR, microperimetry visual field, OCT, OCTA, FAF, and FFA. Multimodal imaging provides precious and detailed information to further clarify the characteristics and development of this rare disease.

摘要

背景

鱼雷样黄斑病变是一种罕见的、良性的先天性黄斑病变,通常呈“鱼雷形”,位于颞侧黄斑区。本研究旨在通过多模态成像详细描述一名中国女性的鱼雷样黄斑病变。

病例介绍

一名30岁中国女性在常规检查中右眼偶然发现黄白色黄斑病变,遂来我院就诊。她无其他症状,双眼最佳矫正视力均为6/6。眼底检查发现右眼颞侧黄斑区有一个鱼雷形、轻度色素减退的病变。红外眼底(IR)图像显示病变轮廓可见,呈横向椭圆形,尖端指向黄斑中心凹。微视野检查视野正常。频域光学相干断层扫描(SD-OCT)显示内视网膜正常,颞侧黄斑区外视网膜和视网膜色素上皮轻度变薄,脉络膜反射率相应增加。其他OCT表现包括外视网膜缺失/变薄,完整的椭圆体带明显萎缩。脉络膜毛细血管层的OCT血管造影(OCTA)显示病变区域对应的脉络膜血管密度增加而浅层和深层血管正常。眼底自发荧光(FAF)显示信号正常,病变鼻侧边缘有轻微高自发荧光。病变的眼底荧光血管造影(FFA)显示荧光斑驳,在整个成像过程中无渗漏及形态改变。

结论

这是首次通过眼底照片、IR、微视野检查、OCT、OCTA、FAF和FFA对鱼雷样黄斑病变进行全面详细描述的报告。多模态成像为进一步阐明这种罕见疾病的特征和发展提供了宝贵而详细的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f2f/6642497/340bb37cf172/12886_2019_1161_Fig1_HTML.jpg

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