国际眼科杂志
國際眼科雜誌
국제안과잡지
INTERNATIONAL JOURNAL OF OPHTHALMOLOGY
2014年
1期
118-121
,共4页
Stargardt病%荧光素%自发性%光学相干断层扫描%多焦视网膜电图%荧光素血管造影
Stargardt病%熒光素%自髮性%光學相榦斷層掃描%多焦視網膜電圖%熒光素血管造影
Stargardt병%형광소%자발성%광학상간단층소묘%다초시망막전도%형광소혈관조영
Stargardt disease%fluorescein%spontaneity%optical coherence tomography%multifocal electroretinograms%fundus fluorescein angiography
目的：分析Stargardt 病中眼底自发荧光（ FAF ）的临床特征，应用频域光学相干断层扫描（ Spectralis OCT ）观察相应的视网膜微结构改变，进一步探讨两者联合应用在Stargardt病诊断中的价值。<br> 方法：非干预性、观察性研究。应用激光共焦扫描检眼镜（德国Heidelberg公司）对Stargardt病患者9例18眼进行蓝光自发荧光（BL-FAF，激发光488nm，滤光片＞500nm）、Spectralis OCT检查、眼底照相、mfERG检查及荧光素眼底血管造影（ fundus fluorescein angiography ，FFA）检查，其中7例同时接受了吲哚青绿血管造影（ indocyanine green angiography ，ICGA）检查；分析Stargardt病FAF分布特征及Spectralis OCT所示视网膜微结构的对应改变。<br> 结果：黄斑部椭圆形病变区域呈现BL-FAF均为低荧光，活动期病例可见边缘厚薄不一的强荧光。 OCT显示病变区视网膜色素上皮（ retinal pigment epithelial ，RPE）和光感受器（photoreceptors，PR）萎缩，神经上皮层菲薄。 FFA早期可出现散在的点状透见荧光，晚期黄斑部出现与萎缩灶大小相符的牛眼状透见荧光；病变晚期ICGA表现为脉络膜毛细血管萎缩，个别病例可见新生血管。<br> 结论：眼底自发荧光联合Spectralis OCT 及mf-ERG是诊断Stargardt病十分有用的非侵入性检查手段，其特征性改变提示病变存在RPE及PR的共同退化，同时也揭示脂褐素这种荧光性物质不同的病理生理变化。
目的：分析Stargardt 病中眼底自髮熒光（ FAF ）的臨床特徵，應用頻域光學相榦斷層掃描（ Spectralis OCT ）觀察相應的視網膜微結構改變，進一步探討兩者聯閤應用在Stargardt病診斷中的價值。<br> 方法：非榦預性、觀察性研究。應用激光共焦掃描檢眼鏡（德國Heidelberg公司）對Stargardt病患者9例18眼進行藍光自髮熒光（BL-FAF，激髮光488nm，濾光片＞500nm）、Spectralis OCT檢查、眼底照相、mfERG檢查及熒光素眼底血管造影（ fundus fluorescein angiography ，FFA）檢查，其中7例同時接受瞭吲哚青綠血管造影（ indocyanine green angiography ，ICGA）檢查；分析Stargardt病FAF分佈特徵及Spectralis OCT所示視網膜微結構的對應改變。<br> 結果：黃斑部橢圓形病變區域呈現BL-FAF均為低熒光，活動期病例可見邊緣厚薄不一的彊熒光。 OCT顯示病變區視網膜色素上皮（ retinal pigment epithelial ，RPE）和光感受器（photoreceptors，PR）萎縮，神經上皮層菲薄。 FFA早期可齣現散在的點狀透見熒光，晚期黃斑部齣現與萎縮竈大小相符的牛眼狀透見熒光；病變晚期ICGA錶現為脈絡膜毛細血管萎縮，箇彆病例可見新生血管。<br> 結論：眼底自髮熒光聯閤Spectralis OCT 及mf-ERG是診斷Stargardt病十分有用的非侵入性檢查手段，其特徵性改變提示病變存在RPE及PR的共同退化，同時也揭示脂褐素這種熒光性物質不同的病理生理變化。
목적：분석Stargardt 병중안저자발형광（ FAF ）적림상특정，응용빈역광학상간단층소묘（ Spectralis OCT ）관찰상응적시망막미결구개변，진일보탐토량자연합응용재Stargardt병진단중적개치。<br> 방법：비간예성、관찰성연구。응용격광공초소묘검안경（덕국Heidelberg공사）대Stargardt병환자9례18안진행람광자발형광（BL-FAF，격발광488nm，려광편＞500nm）、Spectralis OCT검사、안저조상、mfERG검사급형광소안저혈관조영（ fundus fluorescein angiography ，FFA）검사，기중7례동시접수료신타청록혈관조영（ indocyanine green angiography ，ICGA）검사；분석Stargardt병FAF분포특정급Spectralis OCT소시시망막미결구적대응개변。<br> 결과：황반부타원형병변구역정현BL-FAF균위저형광，활동기병례가견변연후박불일적강형광。 OCT현시병변구시망막색소상피（ retinal pigment epithelial ，RPE）화광감수기（photoreceptors，PR）위축，신경상피층비박。 FFA조기가출현산재적점상투견형광，만기황반부출현여위축조대소상부적우안상투견형광；병변만기ICGA표현위맥락막모세혈관위축，개별병례가견신생혈관。<br> 결론：안저자발형광연합Spectralis OCT 급mf-ERG시진단Stargardt병십분유용적비침입성검사수단，기특정성개변제시병변존재RPE급PR적공동퇴화，동시야게시지갈소저충형광성물질불동적병리생리변화。
AIM:To analyze clinical features of Stargardt disease by fundus autofluorescence ( FAF ) and observe microstructural changes of the retina by frequency -domain optical coherence tomography ( Spectralis OCT ) to explore the clinical value of combined FAF and OCT in diagnosis of Stargardt's disease. <br> METHODS: Non -interventional observation study. Confocal scanning laser ophthalmoscope ( Heidelberg, Germany Company) was applied on 9 patients (18 eyes) with Stargardt disease for blue autofluorescence ( BL-FAF, excitation 488nm, filter >500nm), Spectralis OCT examination, fundus photography, mfERG examination and fundus fluorescein angiography ( FFA) examination. Seven cases also received indocyanine green angiography ( ICGA ) inspection. The study analyzed distribution characteristics of Stargardt's disease under FAF examination and microstructural changes of the retina under Spectralis OCT. <br> RESULTS:The BL-FAF of the oval macular lesions presented low fluorescence and visible edge demonstrated varying thickness and strong fluorescence. OCT showed retinal pigment epithelial lesions ( RPE ) , photoreceptors ( PR) atrophy and neurosensory meager. Under FFA examination, scattered point-like fluorescence could be seen in the early stage, and macular atrophy tumor size appears consistent with the bull's -eye fluorescence could be seen in the late stage.The disease demonstrated choriocapillaris atrophy in the late stage under ICGA examination.New vessels could be seen in rare cases. <br> CONCLUSION:FAF with Spectralis OCT and mf-ERG is an effective non -invasive examination methods for diagnosis of Stargardt disease. Changes of its clinical characteristics might suggest degeneration of both RPE and PR and various pathological and physiological changes of lipofuscin.
