1型神经纤维瘤病中脉络膜结节的眼底影像观察  

Fundus image observation of choroidal nodules in neurofibromatosis type 1

作　　者：和丹 张娟[1] 李娟娟[1] He Dan;Zhang Juan;Li Juanjuan(Department of Ophthalmology,Yunnan University Affiliated Hospital,Key Laboratory of Eye Disease Research of Yunnan Province,Yunnan Eye Hospital,Kunming 650021,China)

机构地区：[1]云南大学附属医院眼科、云南省第二人民医院、云南省眼科医院,昆明650021

出　　处：《中华眼底病杂志》2023年第10期823-827,共5页Chinese Journal of Ocular Fundus Diseases

基　　金：云南省卫生健康委员会医学学科带头人培养计划(D-2019021);云南省科技厅-昆明医科大学应用基础研究联合专项(202101AY070001-288)。

摘　　要：目的观察1型神经纤维瘤病(NF1)患者眼底脉络膜结节的影像特征。方法回顾性临床研究。2018年1月至2022年8月于云南大学附属医院眼科检查确诊的NF1合并脉络膜结节患者10例20只眼纳入研究。其中,男性6例12只眼,女性4例8只眼;年龄(28.0±6.9)岁;均为双眼受累。患者均行彩色眼底照相、红外眼底照相(IR)、眼底自身荧光(FAF)、荧光素眼底血管造影(FFA)、光相干断层扫描(OCT)检查。同时行多波长炫彩成像(MC)检查9只眼;行OCT血管成像(OCTA)检查5只眼。观察NF1患者脉络膜结节的眼底彩色照相、IR、眼底FAF、FFA、OCT、MC及OCTA的影像特征。结果20只眼中,眼底彩色照相可见脉络膜结节表面视网膜小血管呈“螺旋样”改变1只眼。FAF、FFA检查,所有患眼均未见异常。IR检查,脉络膜结节表现为大小、数量不等的强反射病灶,呈斑点状和(或)片状,部分融合。行MC检查的9只眼,标准MC像可见斑片状红色信号增加。OCT检查,所有患眼均可见视网膜色素上皮层下脉络膜强反射团块状病灶,呈扁平斑片状或轻度隆起的“圆顶屋样”,与IR强反射病灶相对应;脉络膜毛细血管层被挤压变薄,脉络膜大血管呈弱反射。行OCTA检查的5只眼中,脉络膜结节处脉络膜血管未见丢失以及视网膜浅层、深层毛细血管丛血流密度正常3只眼;脉络膜毛细血管层血流密度降低2只眼。结论脉络膜结节IR特征性表现为大小、数量不等的强反射病灶,呈斑点状和(或)片状;OCT表现为与IR强反射病灶对应处脉络膜毛细血管层反射增强。Objective To observe the imaging characteristics of fundus choroidal nodules in patients with neurofibromatosis type 1(NF1).Methods A retrospective clinical study.From January 2018 to August 2022,20 eyes of 10 patients with NF1 combined with choroidal nodules who were diagnosed by ophthalmology examination at the Affiliated Hospital of Yunnan University were included in the study.Among them,there were 6 male cases with 12 eyes and 4 female cases with 8 eyes;both eyes were affected.Age was(28.0±6.9)years old.Both eyes were involved.All patients underwent color fundus photography,infrared fundus photography(IR),fundus autofluorescence(FAF),fluorescein fundus angiography(FFA),and optical coherence tomography(OCT).Nine eyes underwent multi-wavelength color imaging(MC)and 5 eyes underwent OCT angiography(OCTA).Results In 20 eyes,fundus color photography showed"spiral-like"changes in the small retinal blood vessels on the surface of the choroidal nodules in 1 eye.FAF and FFA examination showed no abnormalities in all affected eyes.On IR examination,choroidal nodules appeared as strong reflective lesions of varying sizes and numbers,in the form of spots and/or sheets,and were partially fused.In the 9 eyes that underwent MC examination,patchy red signals was observed in standard MC images.OCT examination showed that all affected eyes had strong choroidal reflective mass lesions under the retinal pigment epithelium,which were flat patchy or slightly raised“dome-like”,corresponding to IR strong reflective lesions.The choriocapillaris layer was squeezed and thinned,and the large choroidal vessels show weak reflection.Five eyes underwent OCTA examination,there was no loss of blood flow density at the choroidal nodules and the of the superficial an deep retinal capillary plexus in 3 eyes.The choroidal capillary blood flow density was reduced in 2 eyes.Conclusion IR of choroidal nodules is characterized by strong reflection lesions of varying sizes and numbers,which appear in spots and/or sheets.OCT shows enhanced reflect

关 键 词：1型神经纤维瘤病 脉络膜结节 红外照相 体层摄影术 光学相干 

分 类 号：R739.4[医药卫生—肿瘤] R771.3[医药卫生—临床医学]