CAJ | 학술논문

目的探讨多发性一过性白点综合征(MEWDS)患者的眼底白发荧光(FAF)特征.方法回顾性系列病例研究.对2009年1月至2010年12月期间在河北省邢台市眼科医院检查并确诊为MEWDS的8例(8只眼)患者的临床资料进行分析.其中男性3例,女性5例;年龄19～48岁,平均33岁.就诊至发病时间为2～12d,平均6.5d.采用共焦激光扫描仪同步眼底血管造影模式对所有患者进行彩色眼底照相、FAF、荧光素眼底血管造影(FFA)和吲哚氰绿血管造影(ICGA)检查,应用488 nm、787 nm两种波长的激光,同时获得脂褐素和黑色素相关的两种自发荧光,对比观察不同时期动态影像学表现,重点观察患眼眼底白色斑点在自发荧光照相中的改变特征.结果 FAF488nm检查结果显示,所有患眼眼底的灰白色斑点状病灶均呈边界欠清楚的斑片状强自发荧光;FAF787nm检查结果显示无明显异常改变.FAF488nm图像与彩色眼底图像中的灰白色斑点、FFA中的强荧光灶及ICGA后期的弱荧光灶在分布上基本对应.病变痊愈后,FAF488nm图像中的强自发荧光灶也能完全恢复.结论 MEWDS眼底上的斑点状病灶在FAF488nm中呈强自发荧光像,是其特征性自发荧光改变.
목적 탐토다발성일과성백점종합정(MEWDS)환자적안저백발형광(FAF)특정.방법 회고성계렬병례연구.대2009년1월지2010년12월기간재하북성형태시안과의원검사병학진위MEWDS적8례(8지안)환자적림상자료진행분석.기중남성3례,녀성5례;년령19～48세,평균33세.취진지발병시간위2～12d,평균6.5d.채용공초격광소묘의동보안저혈관조영모식대소유환자진행채색안저조상、FAF、형광소안저혈관조영(FFA)화신타청록혈관조영(ICGA)검사,응용488 nm、787 nm량충파장적격광,동시획득지갈소화흑색소상관적량충자발형광,대비관찰불동시기동태영상학표현,중점관찰환안안저백색반점재자발형광조상중적개변특정.결과 FAF488nm검사결과현시,소유환안안저적회백색반점상병조균정변계흠청초적반편상강자발형광;FAF787nm검사결과현시무명현이상개변.FAF488nm도상여채색안저도상중적회백색반점、FFA중적강형광조급ICGA후기적약형광조재분포상기본대응.병변전유후,FAF488nm도상중적강자발형광조야능완전회복.결론 MEWDS안저상적반점상병조재FAF488nm중정강자발형광상,시기특정성자발형광개변.
Objective To observe the imaging features of fundus autofluorescence (FAF) in patients with multiple evanescent white dot syndrome (MEWDS).Methods Retrospective case-series study.Eight cases of MEWDS patients visited Xingtai eye hospital between January 2009 and December 2010were included in this study.Three males and 5 females,aged from 19 to 48 years,mean age was 33 years old.The span between onset and visit to the hospital was between 2 to 12 days,the average time was 6.5 days.All the patients underwent comprehensive ophthalmic examination and fundus color photography,FAF,fluorescein angiography(FFA),indocyanine green angiography (ICGA)by HRA-2.Two different spectrums of autofluorescence excited by laser of 488 nm and 787 nm were recorded,which were related to lipofuscin and melanin respectively.Dynamic imaging changes in different stages were observed and compared.The autofluoresce of fundus with white dot was paid extra attention.Results The white dots in 8 eyes showed strong autofluorescence with a vague boundary in the FAF image excited by laser of 488 nm but normal autofluorescence under the FAF787 nm.The strong autofluorescence of 488 nm agreed with the white dots in the fundus photograph,hyperfluorescence lesions in FFA and the hypofluorescence focus in the later stage of ICGA.After the disease cured,the hyperfluorescence lesions in FFA also faded.Conclusions The fundus autofluorescence features of patients with MEWDS are hyperfluorescence in the site of white dots in FAF488 nm.It is the characteristic change of this disease.