特发性黄斑裂孔眼底自发荧光成像研究

A study on fundus autofluorescence of idiopathic macular hole

目的比较分析特发性黄斑裂孔(IMH)患者眼底自发荧光(FAF)图像及荧光素眼底血管造影(FFA)图像的特征。方法对33例(36眼)IMH患者应用共焦激光扫描检眼镜进行检查,分析FAF图像与FFA图像。另外选取16例正常人作为对照。利用M IG2000图像测量系统对黄斑中心凹进行自发荧光强度测定。结果33例(36眼)IMH患者中,全层黄斑裂孔26眼(72.2%),板层黄斑裂孔10眼(27.7%)。黄斑自发荧光的特征:正常眼底中心凹FAF呈局部低荧光;黄斑裂孔表现为高荧光,与FFA的图像相似。6例板层裂孔FAF、FFA均未见异常,其余4例板层孔中心凹处FFA表现为轻度增强的透见荧光,相应部位FAF见轻度增强的自发荧光。全层黄斑裂孔在裂孔处有明显增强的FAF,FFA的"窗样缺损",在位置、面积、形状上与FAF一致。结论FAF检测为黄斑裂孔的诊断提供了一个新的、快速、非创性检查手段。

Objective Fundus autofluorescence （FAF） is a recently advanced technique in ophthalmoscopic imaging. Observing the intensity and distribution of FAF of various retinal diseases is helpful for ascertaining diagnosis and evaluating prognosis. This study was to analyse the characters of FAF and fundus fluorescein angiography（FFA） of idiopathic macular hole. Methods Thirty-six eyes of 33 cases with idiopathic macular holes were examined with eonfoeal laser scanning ophthalmoscope. Images of FAF and FFA were analysed. The control group included 16 normal subjects. The autofluorescence intensity of fovea were measured by MIG2000 image analysis system. The statistical analysis was carried out by means of SPSS 10.1 software using one-way ANOVA followed by LSD-t test. Results Full thickness maeular holes were found in 26 eyes and lamellar holes were in 10 eyes. The characters of FAF of macula included local hypofluorescenc in normal fovea,bright fluorescence similar to FFA in macular holes. In 10 eyes with lamellar holes,6 eyes showed normal fluorescence appearance on FFA and FAF,and other 4 eyes presented slight autofluoreseence at fovea on FAF and mild transmitted fluorescence on FFA. The fluorescein angiogram of full thickness macular holes showed a window-like fluorescence defect with corresponding location, size, and shape to intense autofluorescence on FAF. The influoreseence of FAF in full thickness macular hole was stongest in comparison with lamellar hole and normal macular area（ F = 34. 710 ,P 〈 0. 01 ）. In normal eye, FAF intensity showed significant difference among fovea area, perifovea area and macular area （ F = 24. 770, P 〈 0.01 ）. Conclusion FAF imaging can be used as a new, non-invasive technique in the diagnosis of idiopathic macular hole.