CAJ | 학술논문

目的：观察急性视网膜色素上皮炎( acute retinal pigment epitheltis,ARPE)的临床特征。方法：回顾性分析我院2008-01/2014-01以来临床确诊为ARPE 的36例40眼的临床资料。其中男21例(58.3%),男女比例为1：0.71。发病年龄17~60(平均40.92±7.13)岁。其中32例为单眼发病。 BCVA 0.3~1.0,平均0.50±0.26。所有患者均行BCVA(矫正视力)、眼底彩照、FFA(荧光素眼底血管造影)、OCT(相干光断层扫描)检查。 FFA表现为3种类型：I型为多个“中黑外亮”或“葡萄簇样”的荧光斑；Ⅱ型为I型病灶可见荧光渗漏；Ⅲ型病灶伴CNV形成。 OCT主要表现为以下三种形态：I型多个RPE(色素上皮)层反射断续、增殖病灶。Ⅱ型色素上皮脱离伴局限性神经上皮脱离。Ⅲ型前2型伴发脉络膜新生血管( CNV)。结果：眼底彩照表现为：所有40只患眼黄斑区或其附近均可见多个不连续的、暗灰色斑点伴周围淡晕环。 FFA表现为I型21眼；Ⅱ型17眼；Ⅲ型2眼,Ⅱ型、Ⅲ型与I型间比较BCVA平均值下降,比较有统计学差异( P<0.05)。而同型间不同形态的病例及Ⅱ、Ⅲ型间 BCVA 平均值比较,无统计学差异( P>0.05)。 OCT 主要表现为I型21眼,Ⅱ型17眼,Ⅲ型2眼。 I与Ⅱ、Ⅲ型病例间BCVA平均值比较有统计学差异(P<0.05),而Ⅱ、Ⅲ型病例间BCVA平均值比较无统计学差异( P>0.05)。结论：ARPE眼底主要表现为后极部多个不连续暗灰色病灶,视力损害程度与有无色素上皮屏障功能受破坏及病灶位置有关。 FFA及OCT可表现为3种类型,典型的FFA表现为“中黑外亮”或“葡萄簇样”的荧光斑,是诊断的依据。 OCT能清晰的显示病变各层的组织形态,对ARPE的诊断和鉴别诊断起到愈来愈重要的作用。
목적：관찰급성시망막색소상피염( acute retinal pigment epitheltis,ARPE)적림상특정。방법：회고성분석아원2008-01/2014-01이래림상학진위ARPE 적36례40안적림상자료。기중남21례(58.3%),남녀비례위1：0.71。발병년령17~60(평균40.92±7.13)세。기중32례위단안발병。 BCVA 0.3~1.0,평균0.50±0.26。소유환자균행BCVA(교정시력)、안저채조、FFA(형광소안저혈관조영)、OCT(상간광단층소묘)검사。 FFA표현위3충류형：I형위다개“중흑외량”혹“포도족양”적형광반；Ⅱ형위I형병조가견형광삼루；Ⅲ형병조반CNV형성。 OCT주요표현위이하삼충형태：I형다개RPE(색소상피)층반사단속、증식병조。Ⅱ형색소상피탈리반국한성신경상피탈리。Ⅲ형전2형반발맥락막신생혈관( CNV)。결과：안저채조표현위：소유40지환안황반구혹기부근균가견다개불련속적、암회색반점반주위담훈배。 FFA표현위I형21안；Ⅱ형17안；Ⅲ형2안,Ⅱ형、Ⅲ형여I형간비교BCVA평균치하강,비교유통계학차이( P<0.05)。이동형간불동형태적병례급Ⅱ、Ⅲ형간 BCVA 평균치비교,무통계학차이( P>0.05)。 OCT 주요표현위I형21안,Ⅱ형17안,Ⅲ형2안。 I여Ⅱ、Ⅲ형병례간BCVA평균치비교유통계학차이(P<0.05),이Ⅱ、Ⅲ형병례간BCVA평균치비교무통계학차이( P>0.05)。결론：ARPE안저주요표현위후겁부다개불련속암회색병조,시력손해정도여유무색소상피병장공능수파배급병조위치유관。 FFA급OCT가표현위3충류형,전형적FFA표현위“중흑외량”혹“포도족양”적형광반,시진단적의거。 OCT능청석적현시병변각층적조직형태,대ARPE적진단화감별진단기도유래유중요적작용。
Abstract?AlM:To analyze of the clinical features of acute retinal pigment epitheltis ( ARPE) .?METHODS: The clinical data of 36 ARPE patients ( 40 eyes) attending this center from January 2008 to January 2014 were reviewed retrospectively. Of them, 21 patients (58.3%) were male (male :female=1:0. 71). The mean age was 40. 92±7. 13 years old (range:17~60y). The mean best-corrected visual acuity (BCVA) was 0. 50±0. 26 with a range of 0. 3 ~ 1. 0. Thirty-two patients were unilateral cases. All the patients were examined for BCVA, funds photography, fluorescein fundus angiography ( FFA ) , optical coherence tomography ( OCT) . FFA was shown as three types: type ▏ to multiple "black light" or "grape variety" fluorescent spot; Type II for l lesions visible fluorescence leakage; Type Ⅲ lesions with choroid neovascularization ( CNV ) . OCT was the following three forms: multiple RPE lesions layer reflection intermittent, proliferation ( type ▏); pigment epithelial detachment with limitations neural epithelium ( typeII);types l and ll with CNV ( type Ⅲ) .?RESULTS: Ocular fundus showed that the lesions were multiple dark-gray spots with a dark circumscribed area at the macular or nearby in all 40 eyes. FFA showed:21 eyes were type ▏, 17 eyes were type II and 2 eyes were typeⅢ, BCVA between type ▏ and type II was statistically significant (P<0. 05), the same was between type 芋. BCVA between different cases in the same type and between type II, Ⅲ, was no statistical difference ( P>0. 05). OCT showed 21 eyes wwere type ▏, 17 eyes were type II and type Ⅲ 2 eyes. BCVA average between type▏ andIIwas statistically significant (P<0. 05). The mean BCVA was no statistically significant difference between type II and Ⅲ patients (P>0. 05).?CONCLUSlON:ARPE fundus demonstrated the multiple dark gray discrete lesions, the degree of visual impairment related with the presence of pigment epithelial barrier and lesion location. OCT and FFA characterized three types. FFA is shown as " black light" or " grape variety" fluorescent spot, and is the basis of diagnosis. OCT can display the lesions organization form of each layer clearly. lt plays a more and more important role in the diagnosis and differential diagnosis of ARPE.