CAJ | 학술논문

目的探讨卵黄样黄斑营养不良不同临床分期的眼底表现及眼底荧光血管造影特征,了解卵黄样黄斑营养不良的病变发展情况.方法对2006年1月至2013年1月在云南省第二人民医院眼科就诊的24例(48只眼)卵黄样黄斑营养不良患者的临床资料,按病变进展进行分期,分析各期病变眼底彩照、眼底荧光血管造影、光相干断层扫描结果,并结合相关文献报道,总结该病发展转归及相应的病理生理变化.结果 2只眼为0期,眼底影像学检查均正常.5只眼为Ⅰ期:黄斑区色素紊乱,OCT显示RPE层间见低反射的小裂隙出现.25只眼为Ⅱ期:黄斑区出现卵圆形黄色隆起,眼底荧光血管造影表现为病变区域无荧光或弱荧光区,OCT显示RPE和光感受器层之间有一中等密度反射区域.12只眼为Ⅲ期,眼底卵黄样病变完整性破坏,眼底荧光血管造影显示病变区域荧光形态不规则,OCT显示RPE层增厚、断裂,高反射物质存留.4只眼为Ⅳ期:眼底表现黄斑病变RPE萎缩灶,眼底荧光血管造影显示为边界清晰的瘢痕染色所致的高荧光、合并脉络膜新生血管形成者,可见新生血管荧光渗漏呈强荧光;OCT显示为神经上皮层变薄,RPE层光反射不连续.结论多重眼底影像学技术的联合运用为认识和了解Best卵黄样黄斑营养不良的发病原因、发病部位、病变特征、发展及转归提供了有利的工具.
목적 탐토란황양황반영양불량불동림상분기적안저표현급안저형광혈관조영특정,료해란황양황반영양불량적병변발전정황.방법 대2006년1월지2013년1월재운남성제이인민의원안과취진적24례(48지안)란황양황반영양불량환자적림상자료,안병변진전진행분기,분석각기병변안저채조、안저형광혈관조영、광상간단층소묘결과,병결합상관문헌보도,총결해병발전전귀급상응적병리생리변화.결과 2지안위0기,안저영상학검사균정상.5지안위Ⅰ기:황반구색소문란,OCT현시RPE층간견저반사적소렬극출현.25지안위Ⅱ기:황반구출현란원형황색륭기,안저형광혈관조영표현위병변구역무형광혹약형광구,OCT현시RPE화광감수기층지간유일중등밀도반사구역.12지안위Ⅲ기,안저란황양병변완정성파배,안저형광혈관조영현시병변구역형광형태불규칙,OCT현시RPE층증후、단렬,고반사물질존류.4지안위Ⅳ기:안저표현황반병변RPE위축조,안저형광혈관조영현시위변계청석적반흔염색소치적고형광、합병맥락막신생혈관형성자,가견신생혈관형광삼루정강형광;OCT현시위신경상피층변박,RPE층광반사불련속.결론 다중안저영상학기술적연합운용위인식화료해Best란황양황반영양불량적발병원인、발병부위、병변특정、발전급전귀제공료유리적공구.
Objective To analyze the multimodal fundus imaging of vitelliform macular dystrophy.Methods Optical coherence tomography (OCT),fluorescein fundus angiography (FFA) and fundus photograph were carried out to the vitelliform macular dystrophy in 26 patients.Results Two eyes belonged to stage 0,fundus imaging were normal; 5 eyes belong to stage Ⅰ,pigment disorders can be observed in macular,OCT showed small cracks in RPE; 25 eyes belonged to stage Ⅱ:oval yellow lesions could be observed in macular area,FFA showed no fluorescence or weak fluorescence,OCT showed a medium-density reflective region between RPE and photoreceptor layer; 12 eyes belonged to stage Ⅲ,the integrity of the yolk-like lesions was damaged,FFA revealed irregular fluorescence,OCT showed RPE layer thickened,highly reflective substance remained; 4 eyes belonged to stage Ⅳ:fundus showed macular degeneration and RPE atrophy,FFA revealed a clear boundary high fluorescence due to scar staining,fluorescein leakage could be found in choroidal neovascularization,OCT showed thinning neurosensory layers,RPE layer was not continuous.Conclusions Combined use of multiple fundus imaging techniques provide a favorable tool to understand the characteristics of Best macular dystrophy.