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伏格特-小柳-原田病恢复期视网膜色素上皮和脉络膜的黑色素变化

Melanin change of retinal pigment epithelium and choroid in the convalescent stage of Vogt-Koyanagi-Harada disease.

作者信息

Huang Ying, Yang Ya-Ting, Lin Bing, Huang Sheng-Hai, Sun Zu-Hua, Zhou Rong, Li Ying-Zi, Liu Xiao-Ling

机构信息

School of Ophthalmology & Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China.

出版信息

Int J Ophthalmol. 2020 Dec 18;13(12):1928-1932. doi: 10.18240/ijo.2020.12.13. eCollection 2020.

Abstract

AIM

To observe the melanin change of the retinal pigment epithelium (RPE) and choroid in the convalescent stage of Vogt-Koyanagi-Harada (VKH).

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

方法

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)。

结果

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)。

结论

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。

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