先天性视盘小凹的多模影像学特征分析  

Multimodal imaging analysis of congenital optic disc pit

作　　者：乔芯蕊 周娜磊[1] 马景学[1] 史俊芳[1] 戴丽[1] 刘影[1] 李镱航 史金鑫 安建斌[1] Qiao Xinrui;Zhou Nalei;Ma Jingxue;Shi Junfang;Dai Li;Liu Ying;Li Yihang;Shi Jinxin;An Jianbin(Department of Ophthalmology,Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院眼科,石家庄050000

出　　处：《中华实验眼科杂志》2021年第11期989-996,共8页Chinese Journal Of Experimental Ophthalmology

基　　金：河北省自然科学基金项目(H2019206214);京津冀基础研究合作专项项目(H2019206711)。

摘　　要：目的通过多模影像学对先天性视盘小凹(ODPs)的特征进行全方位分析。方法采用横断面研究方法,收集2009年1月至2020年1月于河北医科大学第二医院眼病中心确诊为先天性ODPs的患者38例38眼,对其眼底照相、频域光相干断层扫描(SD-OCT)、红外成像、眼底自发荧光、荧光素眼底血管造影(FFA)及吲哚菁绿血管造影(ICGA)的影像学结果进行总结分析。结果眼底照相检查结果显示,38例先天性ODPs患者中32眼ODPs位于视盘颞侧或颞下方,4眼位于颞上方,2眼位于视盘中心,为圆形或类圆形灰白色凹陷;29例视盘小凹黄斑病变(ODP-M)患者乳斑间可见边界清或不清的暗红色隆起。SD-OCT检查显示,所有先天性ODPs患者病变区域筛板结构不完整,为无组织反射的暗区,裂隙通向视神经深部;所有ODP-M患者的外核层均存在液体,其中27眼内核层存在液体,13眼神经节细胞层存在液体,4眼内界膜下存在液体;所有ODP-M患者中21眼存在外层视网膜劈裂,27眼存在神经上皮脱离;在伴有神经上皮脱离的患者中,18眼神经上皮下可见点状高反射信号且椭圆体带反射信号减弱或缺失。红外成像显示,先天性ODPs患者视盘颞侧均存在圆形或类圆形低反射区域,ODP-M患者病变部位呈现低反射区域。眼底自发荧光检查显示,27例ODP-M患眼后极部存在与病变范围一致的低荧光区域,其中18眼低荧光区域中心存在颗粒状或片状高荧光区。FFA示,所有先天性ODPs患者ODPs凹陷部位的动脉期造影均呈现局限性低荧光状态,静脉期可见荧光素染料沿视盘颞侧外渗,造影晚期在视盘颞侧边缘形成边界不清的强荧光弧;27例伴有神经上皮脱离的ODP-M患者造影晚期在黄斑病变区域呈高荧光,未见视盘颞侧渗漏的荧光素钠向黄斑区移动。ICGA显示,所有先天性ODPs患者ODPs凹陷部位呈现局限性低荧光区;伴有神经上皮脱离的27例ODP-M患眼病变区呈高荧光状态。�Objective To analyze the characteristics of eyes with congenital optic disc pits(ODPs)through multimodal imaging.Methods A cross-sectional study was conducted.Thirty-eight patients(38 eyes)diagnosed with congenital ODPs in the Second Hospital of Hebei Medical University from January 2009 to January 2020 were enrolled.A comprehensive summary analysis of the imaging results including fundus photography,spectral domain-optical coherence tomography(SD-OCT),infrared imaging,fundus autofluorescence(FAF),fluorescein fundus angiography(FFA)and indocyanine green angiography(ICGA)was performed.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of The Second Hospital of Hebei Medical University(No.2021-P011).Written informed consent was obtained from each subject prior to any medical examination.Results Among the 38 eyes,there were 32 eyes with ODPs located in or below the temporal side of optic disc,4 eyes with ODPs located above the temporal side of optic disc,and 2 eyes with ODPs located at the center of optic disc,which were round or quasi-circular pale depression,and dark red eminences with clear or unclear boundaries between milk spots were found in 29 eyes with optical-disc macular degeneration(ODP-M)by fundus photography.SD-OCT examination showed that the structure of lamina cribrosa in the lesion area in all ODPs patients was incomplete,which presented a dark area with no tissue reflection,and the fissure led to the deep optic nerve.Fluid was found in the outer nuclear layer in all ODP-M patients,and there were 27 eyes with fluid in the inner nuclear layer,13 eyes in the ganglion cell layer,and 4 eyes under the inner limiting membrane.Among the 29 eyes with ODP-M,there were 21 eyes with retinoschisis in outer layer,27 eyes with neuroepithelial detachment.In the 27 eyes with neuroepithelial detachment,spot-like high reflection and reduced or disappeared ellipsoid band reflectance were seen above the neuroepithelium in 18 eyes.In infrared images,there were circular or q

关 键 词：视盘小凹/先天性 视盘小凹黄斑病变 多模影像学分析 频域光相干断层扫描 荧光素眼底血管造影 

分 类 号：R774[医药卫生—眼科]