Nadelmann Jennifer B, Gupta Mrinali P, Kiss Szilard, Askin Gulce, Chan R V Paul, Papakostas Thanos, D'Amico Donald J, Orlin Anton
Ophthalmic Surg Lasers Imaging Retina. 2019 Sep 1;50(9):550-556. doi: 10.3928/23258160-20190905-03.
Localized retinal detachment can appear similar to peripheral retinoschisis (RS) based on clinical exam alone. This study utilized ultra-widefield autofluorescence (UAF) to characterize retinal changes in patients with rhegmatogenous retinal detachment (RRD) compared to RS and to help differentiate these two entities in the era of multimodal imaging.
A retrospective review of 282 eyes undergoing diagnostic UAF. Eyes were excluded if the quality of the color photograph or UAF prevented reliable evaluation, or if they contained significant peripheral retinal pathology such as diabetic retinopathy or retinal vein occlusions. Eyes were determined to have RRD or RS based on dilated fundus examination, ultrasound, and optical coherence tomography imaging consistent with the diagnosis.
Fifty-three eyes were included; 38 had retinal detachment, and 25 had RS. Eyes were determined to be bullous or not from the color photographs. Based on all UAFs reviewed, images were determined to have granular, normal, hypo-, hyper-, or mixed autofluorescence patterns. The posterior border of the RRD and RS was evaluated separately and determined to have hyper-, hypo-, granular, mixed, or normal autofluorescence. Thirty-three eyes with RRD (86.8%) appeared bullous compared to 12 eyes with RS (48%; P = .002). UAF was considered granular in zero (0%) of RRD eyes and one (4%) RS eye, normal in one RRD eye (2.63%) and 17 (68%) RS eyes, hypoautofluorescent in 27 (71.1%) RRD eyes and four (16%) RS eyes, hyperautofluorescent in one (2.63%) RRD eye and one (4%) RS eye, and mixed in nine (4%) RRD eyes and two (8%) RS eyes (P < .001). When evaluating the posterior leading edge on UAF, 84.2% (n = 32) of patients with RRD had a hyperautofluorescent leading edge compared to 25% (n = 6) of patients with RS (P < .001). UAF was homogenous in 65.8% (n = 25) of cases of RRD versus in 92% (n = 23) of cases of RS (P = .037).
To the authors' knowledge, this is the first study to utilize UAF imaging to differentiate RRD and RS. Findings suggest there are differences between RRD and RS with regards to UAF, UAF of the posterior border, and homogeneity of the area affected. UAF should be considered in the era of multimodal imaging, particularly when clinical exam alone is inadequate to differentiate these two entities. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:550-556.].
仅基于临床检查，局限性视网膜脱离可能看起来与周边视网膜劈裂（RS）相似。本研究利用超广角自发荧光（UAF）来描述孔源性视网膜脱离（RRD）患者与RS患者的视网膜变化，并在多模态成像时代帮助区分这两种情况。
对282只接受诊断性UAF检查的眼睛进行回顾性研究。如果彩色照片或UAF的质量妨碍了可靠评估，或者眼睛存在显著的周边视网膜病变，如糖尿病视网膜病变或视网膜静脉阻塞，则将这些眼睛排除。根据散瞳眼底检查、超声和光学相干断层扫描成像结果，确定眼睛患有RRD或RS，且结果与诊断一致。
纳入53只眼睛；38只患有视网膜脱离，25只患有RS。根据彩色照片确定眼睛是否为大泡性。基于所有回顾的UAF图像，确定图像具有颗粒状、正常、低荧光、高荧光或混合自发荧光模式。分别评估RRD和RS的后缘，并确定其具有高荧光、低荧光、颗粒状、混合或正常自发荧光。33只RRD眼睛（86.8%）表现为大泡性，而12只RS眼睛（48%）表现为大泡性（P = 0.002）。RRD眼睛中0%（0只）和RS眼睛中4%（1只）的UAF被认为是颗粒状，RRD眼睛中2.63%（1只）和RS眼睛中68%（17只）的UAF是正常的，RRD眼睛中71.1%（27只）和RS眼睛中16%（4只）的UAF是低自发荧光的，RRD眼睛中2.63%（
