CAJ | 학술논문

目的观察多发性一过性白点综合征(MEWDS)患者光相干断层扫描(OCT)图像特征及中心凹下脉络膜厚度(SFCT).方法临床检查确诊的MEWDS患者10例10只眼(病例组)纳入研究,选取年龄、性别、屈光状态相匹配的10名正常人作为正常对照组.患者中女性9例9只眼,男性1例1只眼;平均年龄(27±8)岁.出现症状至就诊时间为5～14 d.以发病后2周内为急性期;发病8周后为恢复期.所有患者均行矫正视力、裂隙灯显微镜、直接和(或)间接检眼镜、眼底彩色照相、荧光素眼底血管造影、吲哚青绿血管造影、OCT检查.采用Spectralis-OCT仪增强深部成像技术测量病例组患眼和对侧眼黄斑区中心凹下脉络膜厚度(SFCT).平均随访时间5个月.观察病变急性期和恢复期患眼OCT图像特征,以及患眼和对侧眼SFCT的变化.结果病例组患眼病变急性期后极部光感受器内外节连接(IS/OS)光带均明显紊乱,变薄、缺失、不连续及反光减弱;恢复期IS/OS光带连续性及厚度恢复.患眼病变急性期、恢复期平均SFCT分别为(239.0±140.7)、(189.9±115.6)μtm;恢复期SFCT较急性期明显变薄,差异有统计学意义(t=5.287,P＜0.05).病变急性期、恢复期对侧眼平均SFCT分别为(214.6±127.2)、(186.5±108.6) μm;恢复期SFCT较急性期明显变薄,差异有统计学意义(t=3.553,P＜0.05).正常对照组受检眼SFCT为(155.5±83.5) μm.病例组患眼急性期SFCT较正常对照组明显增厚,差异有统计学意义(Z=一2.117,P＜0.05).结论 MEWDS患眼病变急性期IS/OS光带明显紊乱,变薄、缺失,外核层间见点状强反射信号;双眼病变急性期SFCT均较恢复期增厚,患眼急性期SFCT较正常人增厚.
목적 관찰다발성일과성백점종합정(MEWDS)환자광상간단층소묘(OCT)도상특정급중심요하맥락막후도(SFCT).방법 림상검사학진적MEWDS환자10례10지안(병례조)납입연구,선취년령、성별、굴광상태상필배적10명정상인작위정상대조조.환자중녀성9례9지안,남성1례1지안;평균년령(27±8)세.출현증상지취진시간위5～14 d.이발병후2주내위급성기;발병8주후위회복기.소유환자균행교정시력、렬극등현미경、직접화(혹)간접검안경、안저채색조상、형광소안저혈관조영、신타청록혈관조영、OCT검사.채용Spectralis-OCT의증강심부성상기술측량병례조환안화대측안황반구중심요하맥락막후도(SFCT).평균수방시간5개월.관찰병변급성기화회복기환안OCT도상특정,이급환안화대측안SFCT적변화.결과 병례조환안병변급성기후겁부광감수기내외절련접(IS/OS)광대균명현문란,변박、결실、불련속급반광감약;회복기IS/OS광대련속성급후도회복.환안병변급성기、회복기평균SFCT분별위(239.0±140.7)、(189.9±115.6)μtm;회복기SFCT교급성기명현변박,차이유통계학의의(t=5.287,P＜0.05).병변급성기、회복기대측안평균SFCT분별위(214.6±127.2)、(186.5±108.6) μm;회복기SFCT교급성기명현변박,차이유통계학의의(t=3.553,P＜0.05).정상대조조수검안SFCT위(155.5±83.5) μm.병례조환안급성기SFCT교정상대조조명현증후,차이유통계학의의(Z=일2.117,P＜0.05).결론 MEWDS환안병변급성기IS/OS광대명현문란,변박、결실,외핵층간견점상강반사신호;쌍안병변급성기SFCT균교회복기증후,환안급성기SFCT교정상인증후.
Objective To observe the characteristic of optical coherence tomography (OCT) and subfoveal choroidal thickness(SFCT) in patients with multiple evanescent white dot syndrome (MEWDS).Methods The clinical data of 10 patients (10 eyes)with MEWDS were included in the study.10 normal subjects with matched age, gender and ocular refractive status was selected as control.The patients including 9 females (9 eyes) and 1 male (1 eye), with the average age of (27 ±8) years.The onset time ranged from 5 to 14 days.The patients were in acute phase if it was in 2 weeks after onset, or convalescent phase if onset was 8 weeks ago.The corrected vision, slit lamp biomicroscopy, ophthalmoscope, fundus photography, fundus fluorescein angiography, indocyanine green angiography and optical coherence tomography (OCT) were performed alone or combined in all patients.The SFCT between the acute and convalescent phases were measured using enhanced depth imaging OCT.The average follow-up was 5 months.The OCT characteristics of affected eyes between acute and convalescent phase were compared.The SFCT of the affected eyes and fellow eye were compared.Results The foveal inner segment-outer segment (IS/OS) was disrupted, thin, irregular in the acute phase, and restored in the convalescent phase.The SFCT of patients in the acute phase was (239± 140.7) μm, in the convalescent phase was (189.9±115.6) μm.The SFCT in the acute phase was more thicker than the convalescent phase (t=5.287, P＜0.05).The SFCT of fellow eyes in the acute phase was (214.6±127.2) μm, in the convalescent phase was (186.5± 108.6) μm, the difference was significant (t =3.553, P＜0.05).The SFCT in the control subject was (155.5±83.5) μm.The SFCT in the acute phase was thicker than the control(Z=-2.117, P＜0.05).Conclusions In the acute phase of MEWDS, the foveal IS/OS was disrupted, thin and irregular in OCT scan.The choroid is thicker in the acute phase than in the convalescent phase in both eyes, and thicker than controls.