Huang Ying, Yang Ya-Ting, Lin Bing, Huang Sheng-Hai, Sun Zu-Hua, Zhou Rong, Li Ying-Zi, Liu Xiao-Ling
School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.
Int J Ophthalmol. 2020 Dec 18;13(12):1928-1932. doi: 10.18240/ijo.2020.12.13. eCollection 2020.
To observe the melanin change of the retinal pigment epithelium (RPE) and choroid in the convalescent stage of Vogt-Koyanagi-Harada (VKH).
A retrospective study was performed on 40 eyes of 20 patients in the convalescent stage of VKH. Fundus photography (FP), multi-spectral imaging (MSI), and optical coherence tomography (OCT) were performed.
In the VKH convalescent stage, focal RPE melanin accumulation (FRMA) was detected in 34 eyes (85%) on MSI and in 7 eyes (17.5%) on FP. FRMA was limited to the previous retinal detachment area in all 28 eyes (FRMA was detected in 34 eyes on MSI, which were enrolled, and 6 eyes lacked data in the acute stage). Sunset-glow fundus was detected in 20 eyes (50%) on FP. The mean density of FRMA in a 1-mm-diameter circular area of the fovea was 0.04±0.07 on MSI, which was significantly correlated with sunset-glow fundus (ρ=0.467, =0.02).
In the VKH convalescent stage, FRMA is derived from the RPE melanin change, and sunset-glow fundus is derived from the choroid melanin change. A higher density of FRMA in the fovea and sunset-glow fundus represents more serious depigmentation of melanin.
观察Vogt-小柳-原田病（VKH）恢复期视网膜色素上皮（RPE）和脉络膜的黑色素变化。
对20例VKH恢复期患者的40只眼进行回顾性研究。进行了眼底照相（FP）、多光谱成像（MSI）和光学相干断层扫描（OCT）。
在VKH恢复期，MSI检查发现34只眼（85%）存在局灶性RPE黑色素积聚（FRMA），FP检查发现7只眼（17.5%）存在。所有28只眼中（MSI检查发现34只眼存在FRMA，纳入研究，6只眼急性期数据缺失），FRMA均局限于先前视网膜脱离区域。FP检查发现20只眼（50%）存在晚霞样眼底。MSI检查发现黄斑中心凹直径1mm圆形区域内FRMA的平均密度为0.04±0.07，与晚霞样眼底显著相关（ρ=0.467，P=0.02）。
在VKH恢复期，FRMA源于RPE黑色素变化，晚霞样眼底源于脉络膜黑色素变化。黄斑中心凹FRMA密度较高和晚霞样眼底提示黑色素脱失更严重。
