黄斑营养不良的自发荧光照相观察  

Fundus Autofluorescence in Macular Dystrophy

作　　者：马凯[1] 纪海霞[1] 严伟[1] 熊颖[1] 张风[1] 刘宁朴[1] 

机构地区：[1]首都医科大学附属北京同仁医院、北京同仁眼科中心、北京市眼科与视觉科学重点实验室

出　　处：《首都医科大学学报》2010年第1期31-35,共5页Journal of Capital Medical University

基　　金：国家自然科学基金(30772378);北京市自然科学基金(7072020)资助项目~~

摘　　要：目的初步探讨自发荧光照相在黄斑营养不良临床诊断中的应用价值。方法共收集黄斑营养不良13例(男性8例,女性5例)。常规临床检查手段包括现病史及家族史询问、视力检查、裂隙灯前节检查、间接眼底镜检查、彩色眼底像、荧光血管造影和自发荧光照相,其中部分患者为了进一步明确诊断,接受了视网膜电流图、眼电图、光学相干断层成像检查。对上述患者的彩色眼底像、荧光血管造影和自发荧光照相结果进行比较分析,归纳黄斑营养不良自发荧光图像特征。结果病变区在488 nm自发荧光下呈现与彩色眼底照相与眼底荧光造影所见病变部位相应的低荧光区域,低荧光区域的大小、低荧光的程度与疾病病程和视力损害程度呈现一定相关性。7例患者在黄斑病变区周围可见宽窄不同的环形高荧光条带,提示病变进展的倾向。2例在黄斑区外呈现广泛的高自发荧光,患者否认夜盲症状,视网膜电流图显示为重度的视锥细胞功能损害和轻度的视杆细胞功能损害,提示可能是锥-杆细胞营养不良的早期阶段。红外自发荧光(820 nm)均可以见到上述病灶的显影。结论自发荧光照相作为一种新的无创性检查手段,在黄斑营养不良的诊疗中具有一定的应用价值。Objective To assess the value of autofluorescence photography in diagnosis and treatment of macular dystrophy by observing the characteristics of autofluorescence in such diseases. Methods Thirteen cases of macular dystrophy were enrolled, of whom 8 were male, and 5 were female. The routine clinical examinations included present history, family history, visual test, slitlamp examination, indirect funduscopy, color fundus image, fundus autofluorescence angiography（FFA） and autofluorescence photography. Some of the patients also did the examinations of electroretinogram（ERG）, electro-oculogram（EOG） and ocular coherence tomography（OCT）. By comparing the color fundus images, the FFA images with the autofluorescence images, we summarized the characteristics of autofluorescence in macular dystrophy. Results The central region of the disease presented hypo-autofluorescence（488 nm） corresponding to the disease region of color fundus image and FFA image. There were hyperfluorescence circles with different width around the central region in 7 cases, which may represent disease progression. We could see extensive hyper-autofluorescence out of the macula in 2 patients who denied night blindness. ERG showed serious cone dysfunction and small rod dysfunction, which may represent the early stage of cone-rod dystrophy. The disease image could also be seen by infrared autofluorescence（820 nm）. Conclusion During the observation of macular dystrophy, correct interpretation of autofluorescence images can help to obtain many disease-related information. Autofluorescence photography can reflect the tissue metabolic activity, which becomes it＇s unique superiority in observing such disease. As a non-invasive examination, autofluorescence photography can be accepted more easily by follow-up patients, which is useful in clinic to some extent.

关 键 词：自发荧光 黄斑营养不良 遗传 

分 类 号：R770.43[医药卫生—眼科]