维生素 A 缺乏性视网膜病变患者的多模态影像学研究。

Multimodal Imaging Study of Patients With Vitamin A Deficiency Retinopathy.

出版信息

Ophthalmic Surg Lasers Imaging Retina. 2023 Jun;54(6):330-336. doi: 10.3928/23258160-20230513-01. Epub 2023 Jun 1.

DOI:10.3928/23258160-20230513-01

PMID:37352397

Abstract

OBJECTIVES

To describe multimodal imaging findings of vitamin A deficiency retinopathy.

METHODS

A retrospective study of patients with serum retinol < 0.3 mg/L. Fundus color photos, spectral domain-optical coherence tomography (SD-OCT), and fundus autofluorescence (FAF) were reviewed and, when available, electrophysiological tests were analyzed.

RESULTS

Forty-five eyes (63.9 ± 15.7 years) were included. Ultra-widefield fundus photography showed drusen-like deposits (53.3%) and macular retinal pigment epithelium (RPE) mottling (40%). The deposits were hypoautofluorescent, and a perifoveal hyperautofluorescent ring was present in 8.9%. By SD-OCT, the ellipsoid zone had an irregular appearance (100%) and conical deposits anterior to the RPE (33.3%). Electroretinogram (ERG) (66.7%) showed a decrease in b-wave in the scotopic registers, and microperimetry (4.4%) showed decreased foveal sensitivity. After vitamin A supplementation, SD-OCT and FAF showed resolution of all findings. Forty percent of eyes had restoration of the scotopic registers in ERG and improved macular sensitivity by microperimetry (4.4%).

CONCLUSIONS

Vitamin A deficiency causes a mild cone dysfunction in addition to the more severe absent rod response. .

摘要

目的

描述维生素 A 缺乏性视网膜病变的多模态成像表现。

方法

回顾性研究血清视黄醇 < 0.3 mg/L 的患者。回顾眼底彩色照片、谱域光相干断层扫描（SD-OCT）和眼底自发荧光（FAF），并分析可获得的电生理检查结果。

结果

共纳入 45 只眼（63.9 ± 15.7 岁）。超广角眼底摄影显示类脂沉积（53.3%）和黄斑视网膜色素上皮（RPE）斑点（40%）。沉积物表现为低自发荧光，在 8.9%的患者中存在中心凹周围高自发荧光环。SD-OCT 显示椭圆体带外观不规则（100%）和 RPE 前锥形沉积物（33.3%）。视网膜电图（ERG）（66.7%）显示暗视条件下 b 波下降，微视野（4.4%）显示中心凹敏感性下降。补充维生素 A 后，SD-OCT 和 FAF 显示所有发现均得到解决。40%的眼在 ERG 中恢复了暗视条件下的记录，微视野（4.4%）显示黄斑敏感性提高。