急性区域性隐匿性外层视网膜病变的研究进展  

Research advances in acute zonal occult outer retinopathy

作　　者：郝昕蕾 金玮[1] 袁满 杨安怀[1] Hao Xinlei;Jin Wei;Yuan Man;Yang Anhuai(The Eye Centerof Renmin Hospital of Wuhan University,Hubei Province,430060,China)

机构地区：[1]武汉大学人民医院眼科中心,430060

出　　处：《临床眼科杂志》2022年第1期89-93,共5页Journal of Clinical Ophthalmology

基　　金：湖北省自然科学基金面上项目。

摘　　要：急性区域性隐匿性外层视网膜病变(AZOOR)是一种少见的单眼或双眼发病的外层视网膜疾病,病因尚不明确,好发于年轻女性,近视人群发病常见。主要表现为:突发闪光感、眼前暗点、视力下降,眼底无明显异常或改变轻微。视野改变以生理盲点扩大为主,伴或不伴其他形式视野缺损,全视野视网膜电图(ERG)振幅及潜伏期异常,多焦视网膜电图表现为与视野缺损区一致的振幅降低。影像改变具有多样性,主要表现为吲哚青绿眼底血管造影(ICGA)、眼底自发荧光(FAF)、频域相干光层析成像术(SD-OCT)上涉及外层视网膜、视网膜色素上皮层、脉络膜层的典型三区带状改变和病灶边界特征性AZOOR线,后者以FAF上表现最明显。超广角成像技术的发展为周边病变区的检出提供了条件。目前认为该病具有一定的自限性,尚无统一的治疗标准。为加强对该病的认识,本文对AZOOR的概念、发病特点及临床特征、辅助检查、鉴别诊断、病因假说和治疗与预后等进行综述。Acute zonal occult outer retinopathy(AZOOR)is a rare unilateral or bilateral outer retinopathy of unclear etiology.It occurs predominantly in young myopic women.The majority of patients complain about acute onset of photopsia associated with scotoma and decreased vision acuity.Fundus examination is normal or minimal changes.The change of visual field is mainly blind spot enlargement with or without other field defects.Full field electroretinographic abnormalities are recorded,including depressed amplitude and delayed latency.Multifocal electroretinography shows zonal amplitude reduction consistent with visual filed defects.The disease expresses variability in multimodal imaging.The characteristic features include a demarcating line at the lesion border,which is best seen with FAF imaging,and a trizonal pattern of involvement of outer retina,retinal pigment epithelium,and choroid in indocyanine green angiography,fundus autofluorescence and spectral-domain optical coherence tomography.The development of ultra-wide-field imaging technology makes it precise to detect peripheral lesions.It is believed the disease is partly self-limited and no studies hitherto have established an effective treatment.To enhance the understanding of AZOOR,the concept,clinical feature,auxiliary examination,differential diagnosis,etiological hypothesis,treatment and prognosis of AZOOR are described in detail in this paper.

关 键 词：急性区域性隐匿性外层视网膜病变 眼底自发荧光成像 频域相干光层析成像术 视觉电生理检查 视野 综述 

分 类 号：R774.1[医药卫生—眼科]