急性区域性隐匿性外层视网膜病变的多模式光学影像学观察
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摘要
目的:观察和分析急性区域性隐匿性外层视网膜病变(AZOOR)患者的光学影像学检查结果,描述该类疾病特征性的光学影像学表现。方法:回顾性分析2017年5月～2018年9月在中国科学技术大学附属第一医院眼科诊断为AZOOR的6例患者的眼科专科检查报告,并测量4例患者黄斑区域3个点的脉络膜厚度,进行综合分析。结果:所有患者视野检查结果均表现为不同程度的缺损,所有患者光相干断层扫描(OCT)检查结果均表现为椭圆体区反光带存在不同程度的异常,5例患者眼底自发荧光(FAF)检查结果显示出不同大小和位置的高荧光区域,所有患者吲哚青绿血管造影(ICGA)检查结果的晚期均显示出不同大小和位置的低荧光区域。在黄斑中心凹鼻侧500μm处,对侧眼脉络膜厚度与患侧眼脉络膜厚度呈正相关(r=0.970,P<0.05)。结论:AZOOR的主要影像学特点是视野不同程度的缺损,OCT检查中病灶处椭圆体反光带的异常,FAF检查中的高荧光区域以及ICGA检查晚期的低荧光区域,但这些特征可能需要更大的样本量进行验证。
Objective:To observe the optical imaging of acute zonal occult outer retinopathy(AZOOR),and describe the characteristic optical imaging findings of AZOOR.Methods:Retrospective analysis was performed on the optical imaging reports of 6 cases of confirmed AZOOR in the First Affiliated Hospital of USTC between May 2017 and September 2018.Choroidal thicknesses was measured at three sites in the macula in 4 cases to analyze the optical imaging findings.Results:Visual field examination and optical coherence tomography(OCT) respectively revealed defect and abnormality in the reflective band of ellipsoid zone in all cases in different degrees.Fundus autofluorescence(FAF) detection showed high fluorescence region in different size and position in 5 cases,and indocyanine green angiography(ICGA) examination indicated low fluorescence region in different size and position in late stage in all cases.Positive correlation between the choroidal thickness of the contralateral eye and the choroidal thickness of the affected eye was seen at 500 μm of the nasal side of the fovea centralis(r=0.970,P<0.05).Conclusion:The main optical imaging features of AZOOR are associated with defect of visual field,abnormality of ellipsoid zone reflective band in OCT,high fluorescence area in FAF and the low fluorescence area in late ICGA,yet needs to be further verified in larger sample size.
Objective:To observe the optical imaging of acute zonal occult outer retinopathy(AZOOR),and describe the characteristic optical imaging findings of AZOOR.Methods:Retrospective analysis was performed on the optical imaging reports of 6 cases of confirmed AZOOR in the First Affiliated Hospital of USTC between May 2017 and September 2018.Choroidal thicknesses was measured at three sites in the macula in 4 cases to analyze the optical imaging findings.Results:Visual field examination and optical coherence tomography(OCT) respectively revealed defect and abnormality in the reflective band of ellipsoid zone in all cases in different degrees.Fundus autofluorescence(FAF) detection showed high fluorescence region in different size and position in 5 cases,and indocyanine green angiography(ICGA) examination indicated low fluorescence region in different size and position in late stage in all cases.Positive correlation between the choroidal thickness of the contralateral eye and the choroidal thickness of the affected eye was seen at 500 μm of the nasal side of the fovea centralis(r=0.970,P<0.05).Conclusion:The main optical imaging features of AZOOR are associated with defect of visual field,abnormality of ellipsoid zone reflective band in OCT,high fluorescence area in FAF and the low fluorescence area in late ICGA,yet needs to be further verified in larger sample size.
引文
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[3] MAEHARA H,SEKIRYU T,SUGANO Y,et al.Choroidal thickness changes in acute zonal occult outer retinopathy [J].Retina,2019,39(1):202-209.
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[5] DUNCKER T,LEE W,JIANG F,et al.Acute zonal occult outer retinopathy:structural and functional analysis across the transition zone between healthy and diseased retina [J].Retina,2018,38(1):118-127.
[6] SAKAI T,GEKKA T,KOHZAKI K,et al.Improved photoreceptor function in male acute zonal occult outer retinopathy [J].Optometry and vision science:official publication of the American Academy of Optometry,2015,92(10):e371-379.
[7] HASHIMOTO Y,SAITO W,SAITO M,et al.Relationship between choroidal thickness and visual field impairment in acute zonal occult outer retinopathy [J].Journal of Ophthalmology,2017,2017:2371032.
[8] WANG Q,JIANG L,YAN W,et al.Fundus autofluorescence imaging in the assessment of acute zonal occult outer retinopathy [J].Ophthalmologica,2017,237(3):153-158.
[9] FUJIWARA T,IMAMURA Y,GIOVINAZZO V J,et al.Fundus autofluorescence and optical coherence tomographic findings in acute zonal occult outer retinopathy [J].Retina,2010,30(8):1206-1216.
[10] MAKINO S,TANAKA Y,TAMPO H.An optical coherence tomography and fundus autofluorescence imaging study of peripapillary acute zonal occult outer retinopathy [J].Case Reports in Ophthalmology,2013,4(1):11-16.
[11] FREUND K B,MREJEN S,JUNG J,et al.Increased fundus autofluorescence related to outer retinal disruption [J].JAMA Ophthalmology,2013,131(12):1645-1649.
[2] MREJEN S,KHAN S,GALLEGO-PINAZO R,et al.Acute zonal occult outer retinopathy:a classification based on multimodal imaging [J].JAMA Ophthalmology,2014,132(9):1089-1098.
[3] MAEHARA H,SEKIRYU T,SUGANO Y,et al.Choroidal thickness changes in acute zonal occult outer retinopathy [J].Retina,2019,39(1):202-209.
[4] GASS JD.Are acute zonal occult outer retinopathy and the white spot syndromes (AZOOR complex) specific autoimmune diseases[J]?American Journal of Ophthalmology,2003,135(3):380-381.
[5] DUNCKER T,LEE W,JIANG F,et al.Acute zonal occult outer retinopathy:structural and functional analysis across the transition zone between healthy and diseased retina [J].Retina,2018,38(1):118-127.
[6] SAKAI T,GEKKA T,KOHZAKI K,et al.Improved photoreceptor function in male acute zonal occult outer retinopathy [J].Optometry and vision science:official publication of the American Academy of Optometry,2015,92(10):e371-379.
[7] HASHIMOTO Y,SAITO W,SAITO M,et al.Relationship between choroidal thickness and visual field impairment in acute zonal occult outer retinopathy [J].Journal of Ophthalmology,2017,2017:2371032.
[8] WANG Q,JIANG L,YAN W,et al.Fundus autofluorescence imaging in the assessment of acute zonal occult outer retinopathy [J].Ophthalmologica,2017,237(3):153-158.
[9] FUJIWARA T,IMAMURA Y,GIOVINAZZO V J,et al.Fundus autofluorescence and optical coherence tomographic findings in acute zonal occult outer retinopathy [J].Retina,2010,30(8):1206-1216.
[10] MAKINO S,TANAKA Y,TAMPO H.An optical coherence tomography and fundus autofluorescence imaging study of peripapillary acute zonal occult outer retinopathy [J].Case Reports in Ophthalmology,2013,4(1):11-16.
[11] FREUND K B,MREJEN S,JUNG J,et al.Increased fundus autofluorescence related to outer retinal disruption [J].JAMA Ophthalmology,2013,131(12):1645-1649.