Ⅰ型急性区域性隐匿性外层视网膜病变的眼底影像学特征  

Imaging characteristics of type Ⅰ acute zonal occult outer retinopathy

作　　者：周波 杨嘉嵩 刘华 胡玉章 

机构地区：[1]成都爱迪眼科医院,成都610072

出　　处：《中国实用眼科杂志》2015年第12期1402-1405,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的分析整理Ⅰ型急性区域性外层视网膜病变（AZOOR）的各种眼底及影像学所见，探讨Ⅰ型AZOOR的影像学特征。方法于2013年4月至2013年8月在成都爱迪眼科医院门诊临床确诊的Ⅰ型AZOOR患者3例3只眼，患者均为女性，单眼发病，年龄33—51岁。患者均行最佳矫正视力、裂隙灯显微镜、眼底彩色照相、视野、SD—OCT、眼底自发荧光、眼部电生理检查。其中1例行眼底荧光素血管造影检查。回顾分析患者的临床资料和各种眼底影像学图像。结果3例患者的患眼眼科常规检查均无明显异常表现。视野检查患眼均有生理盲点扩大或与生理盲点相连的局部视野损害或散在暗点。ERG检查2例患者患眼暗视及明视ERG振幅均较对侧眼降低，1例无明显改变。1例FFA检查可见后极部早期背景荧光略增强，余无特殊改变。SD—OCT检查3例患眼均有后极部或与视野相对应部位视网膜的光感受器内外节连接线（IS／OS）紊乱或局部缺失。1例患眼的眼底白发荧光表现为后极部的高荧光，并且与IS／OS缺失相吻合。结论Ⅰ型AZOOR的临床体征表现隐匿，借助眼底影像学检查有助于明确诊断。SD—OCT与视野相对应的视网膜外层IS／OS紊乱或缺失是诊断Ⅰ型AZOOR的要点。Objective To analyze and characterize the fundus imagine findings in patients with type Ⅰ acute zonal occult outer retinopathy （AZOOR）. Methods Three female patients （3 eyes） with type Ⅰ AZOOR were enrolled in this study. All patients were unilateral involved （ranged 33 to 51 year-old）. The patients underwent comprehensive eye examinations including best corrected visual acuity, slitlamp biomicroscope, fi.mdus photograph, visual field, SD-OCT, fundus autofluorescence, electroretinogram （ERG）. One of the patients underwent fluorescein angiography. The clinical and the fundus imaging findings were analyzed retrospectively. Results The conventional ophthalmoscope did not find any abnormality of the involved eyes. Visual field of the 3 eyes demonstrated blind spot enlargement, or associated with other visual field defects and scattered scotoma. ERG showed depressed scotopic and photopic amplitudes in 2 eyes. FFA showed enhanced background fluorescence in 1 patient. IS/OS line disruption or loss of the posterior pole or the area corresponding to the visual field loss were detected in all the involved eyes. FAF demonstrated hyperfluorecence of the posterior pole associated with the IS/OS line disruption and the FAF enhanced background fluorescence. Conclusions The clinical signs of type Ⅰ AZOOR are undetectable by conventional examination and the Imaging findings are helpful for the diagnosis. IS/OS line disruption or loss demonstrated by SD-OCT corresponding to visual field abnormality is the key point for the diagnosis of the type Ⅰ AZOOR.

关 键 词：Ⅰ型急性区域性隐匿性外层视网膜病变 频域光学相干断层扫描 感光细胞内外节 

分 类 号：R770.43[医药卫生—眼科]