中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2013年
12期
1586-1590
,共5页
一过性白点综合征%FFA%ICGA
一過性白點綜閤徵%FFA%ICGA
일과성백점종합정%FFA%ICGA
Multiple evanescent white dot syndrome%FFA%ICGA
目的 通过观察多发性一过性白点综合征(MEWDS)急性期和恢复期的视网膜及脉络膜血管造影表现,进一步明确病灶位置.方法 前瞻性系列病例研究.将2010年12月至2011年10月在河北省人民医院眼科确诊的MEWDS 10例患者纳入研究,在急性期及恢复期分别进行FFA、ICGA及视野检查,对比分析造影特点.结果 10例患者均为单眼发病,男3例,女7例,平均28.4岁,随访4～28周.就诊时患眼最佳矫正视力0.25～0.6,眼底表现为后极视网膜多数均匀散在白色点状病灶,边界稍模糊无隆起.在发病4～14周(平均8.4周)时最佳矫正视力均恢复至1.0,眼底白点消失,视野正常.在10只患眼中,彩色像上的白色点状病灶,FFA早期均显示点片状高荧光损害,其中有6只眼同时伴有低荧光损害,晚期均发生荧光素积存轻渗漏;而ICGA晚期出现多数低荧光病灶,且数量较FFA的强荧光病灶更多,范围更清晰.在恢复期有7例患者FFA未见异常而ICGA晚期仍有异常荧光,而另3例患者FFA及ICGA均未见异常.结论 MEWDS发病不同时期病灶位置不同,不仅RPE及光感受器层发生病变,脉络膜的内层及固有层同样受到影响,这就造成了FFA及ICGA造影表现的多样性.
目的 通過觀察多髮性一過性白點綜閤徵(MEWDS)急性期和恢複期的視網膜及脈絡膜血管造影錶現,進一步明確病竈位置.方法 前瞻性繫列病例研究.將2010年12月至2011年10月在河北省人民醫院眼科確診的MEWDS 10例患者納入研究,在急性期及恢複期分彆進行FFA、ICGA及視野檢查,對比分析造影特點.結果 10例患者均為單眼髮病,男3例,女7例,平均28.4歲,隨訪4～28週.就診時患眼最佳矯正視力0.25～0.6,眼底錶現為後極視網膜多數均勻散在白色點狀病竈,邊界稍模糊無隆起.在髮病4～14週(平均8.4週)時最佳矯正視力均恢複至1.0,眼底白點消失,視野正常.在10隻患眼中,綵色像上的白色點狀病竈,FFA早期均顯示點片狀高熒光損害,其中有6隻眼同時伴有低熒光損害,晚期均髮生熒光素積存輕滲漏;而ICGA晚期齣現多數低熒光病竈,且數量較FFA的彊熒光病竈更多,範圍更清晰.在恢複期有7例患者FFA未見異常而ICGA晚期仍有異常熒光,而另3例患者FFA及ICGA均未見異常.結論 MEWDS髮病不同時期病竈位置不同,不僅RPE及光感受器層髮生病變,脈絡膜的內層及固有層同樣受到影響,這就造成瞭FFA及ICGA造影錶現的多樣性.
목적 통과관찰다발성일과성백점종합정(MEWDS)급성기화회복기적시망막급맥락막혈관조영표현,진일보명학병조위치.방법 전첨성계렬병례연구.장2010년12월지2011년10월재하북성인민의원안과학진적MEWDS 10례환자납입연구,재급성기급회복기분별진행FFA、ICGA급시야검사,대비분석조영특점.결과 10례환자균위단안발병,남3례,녀7례,평균28.4세,수방4～28주.취진시환안최가교정시력0.25～0.6,안저표현위후겁시망막다수균균산재백색점상병조,변계초모호무륭기.재발병4～14주(평균8.4주)시최가교정시력균회복지1.0,안저백점소실,시야정상.재10지환안중,채색상상적백색점상병조,FFA조기균현시점편상고형광손해,기중유6지안동시반유저형광손해,만기균발생형광소적존경삼루;이ICGA만기출현다수저형광병조,차수량교FFA적강형광병조경다,범위경청석.재회복기유7례환자FFA미견이상이ICGA만기잉유이상형광,이령3례환자FFA급ICGA균미견이상.결론 MEWDS발병불동시기병조위치불동,불부RPE급광감수기층발생병변,맥락막적내층급고유층동양수도영향,저취조성료FFA급ICGA조영표현적다양성.
Objective To observe the characteristic of multiple evanescent white dot syndrome in FFA and ICGA at it's initial and resume stage,analysis the characteristic of FFA and ICGA to determine the location of the lesions in MEWDS.Methods A prospective case series study.Ten patients diagnosed as MEWDS during the period from December 2010 to October 2011 studied using FFA,ICGA and visual field examination,analysis all outcomes.Results All the MEWDS patients of 10 cases were monocular disease,3 patients were male and 7 patients were female.The mean ages were 28.4 years.The follow up was 4-28 weeks.The mean corrected visual acuity at first visit was 0.42 (0.25-0.6).All patients were found yellow-white leisions located in deep retina throughout the posterior pole with unclear boundary and flat surface.At 4-14 weeks,all patients' corrected visual acuity improved to 1.0,the white dots disappeared ophthalmoscopically,and the visual field resumed.At first visit,corresponding the white dots in fundus,FFA early phases revealed only hyperfluorescence in 4 eyes and a combination of hyper-and hypofluorescence in 6 eyes,and normal early ICGA in all patients; at intermediate-late stages,hyperfluorescence (staining and leakage but very faint) at FFA but hypofluorescence leisions at ICGA in all patients.ICGA detected more and clearer leisions than FFA.Otherwise,when visual acuity improved to 1.0,the white dots disappeared ophthalmoscopically,ICGA intermediate-late hypo-or hyper-fluorescence leisions remain longer than FFA in 7 eyes.Conclusions Angiographic features may vary during the nature evolution of MEWDS,which suggest that not only RPE and photoreceptor are influenced,but also inner and outer choroid are affected in this disorder.
