多发性一过性白点综合征的临床观察  

Clinical observation of multiple evanescent white dot syndrome

作　　者：李志[1,2] 王林丽[1,2] 甘润[1,2] 陈青山[1,2] 

机构地区：[1]暨南大学附属深圳眼科中心 [2]深圳市眼科医院,中国广东省深圳市518040

出　　处：《国际眼科杂志》2013年第11期2322-2324,共3页International Eye Science

摘　　要：目的:观察描述多发性一过性白点综合征(multiple evanescent white dot syndrome,MEWDS)的临床表现。方法:回顾性分析2003-01/2012-11在我院确诊为MEWDS并进行治疗的25例病例临床资料,并对各种影像检查资料进行分析,总结MEWDS的临床及影像学特征。结果:所有患者均伴轻-中度近视,不同程度的视野缺损。MEWDS的荧光素血管造影(FFA)表现为:病灶处呈圆形强荧光斑,随时间延迟荧光强度增强,晚期呈边界不清的强荧光染色,伴有视盘荧光增强,部分伴有节段状血管管壁染色。吲哚青绿血管造影(ICGA)表现为:早期后极部散在的大小不等的相对弱荧光,中晚期渐呈边界清晰的斑片状弱荧光。OCT表现为:病灶部位光感受细胞层厚度不规则、视细胞内节/外节(IS/OS)层的光带局部变薄或缺失,伴反光强度减弱(该部位与血管造影中的异常荧光灶对应),而视网膜内网状层至外核层均未见明显异常。结论:MEWDS患者眼底的斑点状病灶在FFA、ICGA、OCT中均有特征性改变,这些特征性改变提示病变位于视网膜色素上皮和光感受器,这些特征对MEWDS疾病的诊断和鉴别诊断有重要意义。AIM： To observe and describe the clinical manifestations of multiple evanescent white dot syndrome （MEWDS）. ~ METHODS： The clinical data of 25 cases diagnosed as MEWDS from January 2003 to November 2012 in our hospital were retrospectively analyzed. A variety of imaging data were analyzed, and the clinical and imaging features of MEWDS were summarized. ~ RESULTS; All patients with mild to moderate myopia, visual field defect in different degree. Fluorescein angiography （FFA MEWDS） showed： the lesions showed round strong fluorescent spot, with time delayed fluorescence intensity, advanced showed strong fluorescence boundary was not clear staining, optic disc fluorescence enhancement, accompanied by a segment of vascular wall staining. Indocyanine green angiography （ICGA） showed： the relative weak fluorescence early posterior interspersed with different size, advanced gradually with clear boundaries of patchy fluorescence. OCT showed： location photoreceptive cells layer thickness, photoreceptor inner segments of irregular/ outer segment （IS/OS） layer band local thin or missing, with reflective intensity （abnormal fluorescence foci of the part and angiography in the corresponding）, and retinal inner plexiform layer and outer nuclear layer were no obvious abnormalities. ~ CONCLUSION： MEWDS patients with fundus spot like lesions are characteristic in FFA, ICGA, OCT, these features suggest that the lesions were located in the RPE and photoreceptors, these features of MEWDS diseasediagnosis and differential diagnosis.

关 键 词：临床及影像学特征 白点综合征 一过性 多发性 

分 类 号：R774.1[医药卫生—眼科]