多发性一过性白点综合征的多模态影像学：一种新的解读。
Multimodal Imaging of Multiple Evanescent White Dot Syndrome: A New Interpretation.
机构信息
Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco," Luigi Sacco Hospital, University of Milan , Milan, Italy.
Ophthalmology Unit, Ospedale Valduce , Como, Italy.
出版信息
Ocul Immunol Inflamm. 2020 Jul 3;28(5):814-820. doi: 10.1080/09273948.2019.1635169. Epub 2019 Aug 15.
PURPOSE
To investigate the pathogenesis of Multiple Evanescent White Dot Syndrome (MEWDS) using multimodal imaging (MMI).
METHODS
Retrospective case series of 7 patients with acute MEWDS. Each patient underwent: near-infrared reflectance (IR), blue and near-infrared autofluorescence (FAF and NIRAF), fluorescein angiography (FA), indocyanine green angiography (ICGA), enhanced depth imaging optical coherence tomography (EDI-OCT) on Spectralis, and optical coherence tomography angiography on OCTA Spectralis, XR Avanti or Plex Elite 9000.
RESULTS
OCTA and FA findings of early hyperfluorescence depict an unaffected choriocapillaris. On ICGA early to late hypofluorescent lesions corresponded to the hyporeflectivity on IR, consistent with altered reflectivity of the RPE. The SDI-OCT showed ellipsoid zone disruption as confirmed by FAF hyperautofluorescence. Some lesions showed a hypertransmission sign underneath the RPE, possibly due to changes in RPE intracellular melanin as suggested by NIRAF hypoautofluorescence.
CONCLUSIONS
The MMI findings of MEWDS are secondary to RPE reflectivity changes, suggesting its pivotal role.
目的
使用多模式成像（MMI）研究多发性一过性白点综合征（MEWDS）的发病机制。
方法
回顾性分析 7 例急性 MEWDS 患者。每位患者均接受：近红外反射（IR）、蓝色和近红外自发荧光（FAF 和 NIRAF）、荧光素血管造影（FA）、吲哚青绿血管造影（ICGA）、Spectralis 上的增强深度成像光相干断层扫描（EDI-OCT）以及 OCTA Spectralis、XR Avanti 或 Plex Elite 9000 上的光相干断层扫描血管造影。
结果
早期高荧光 OCTA 和 FA 发现描绘了未受影响的脉络膜毛细血管。在 ICGA 中，早期到晚期低荧光病变与 IR 的低反射率相对应，与 RPE 的反射率改变一致。SDI-OCT 显示椭圆体带破坏，FAF 高自发荧光证实。一些病变在 RPE 下方显示出高透过信号，可能是由于 RPE 细胞内黑色素的变化，如 NIRAF 低自发荧光所提示的。
结论
MEWDS 的 MMI 发现继发于 RPE 反射率的变化，提示其关键作用。
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