慢性迁延性中心性浆液性脉络膜视网膜病变的两种自发荧光特征

Characteristics of two autofluorescence in patients with chronic central serous chorioretinopathy

目的对脂褐素相关自发荧光(lipofuscin-related fundus autofluorescence,FAF)和黑色素相关近红外自发荧光(melaninrelated near-infrard fundus autofluorescence,NIA)在慢性迁延性中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)中的特征进行分析。方法回顾性分析慢性迁延性CSC患者57例63眼的临床资料,对经德国海德堡共焦激光扫描眼底血管造影仪检查的FAF、NIA和荧光素眼底血管造影(fundus fluorescence angiography,FFA)图像进行对比分析。结果 63眼中,FAF异常荧光者47眼(占74.6%),包括弱荧光39眼(占83.0%)、强荧光3眼(占6.4%)、不典型荧光5眼(占10.6%);NIA异常荧光者59眼(占93.7%),包括弱荧光48眼(占81.4%)、斑驳状荧光5眼(占8.5%)、不典型荧光6眼(占10.2%)。63眼神经上皮脱离区自发荧光表现:FAF呈异常荧光者50眼(占79.4%),包括弱荧光15眼(占30.0%)、强荧光35眼(占70.0%);NIA异常荧光57眼(占90.5%),包括颗粒样混杂荧光51眼(占89.5%)、弱荧光6眼(占10.5%)。另外,FAF和NIA显示视网膜神经脱离区病变范围大于FFA者分别有23眼和33眼,分别占36.5%和52.4%。FFA和FAF显示正常的区域而NIA表现异常者3眼,占4.8%。结论 NIA联合FAF适合于观察慢性迁延性CSC视网膜色素上皮的变化。

Objective To analyze the characteristics of lipofusin-related autoflu- orescence （FAF） and melanin-related near-infrared fundus autofluorescence （NIA） in patients with chronic central serous chorioretinopathy （CSC）. Methods The images of FAF, NIA and fundus fluorescence angiography （FFA） examined by Spectralis Heidel- berg Retinal Angiograph （ Spectralis HRA） were retrospectively analyzed in 63 eyes of 57 patients with chronic CSC. Results In all the 63 eyes with one or more leakage spots,47 eyes （74. 6% ）showed abnormal autofluorescence on FAF images, including hypoautofluorescence in 39 eyes （ 83.0% ）, hyperautofluorescence in 3 eyes （ 6.4% ）, a- typical autofluorescence in 5 eyes （ 10.6% ） ;59 eyes （93.7%） showed abnormal autoflu- orescence on NIA images, including hypoautofluorescence in 48 eyes （81.4% ）, mottled autofluorescence in 5 eyes （8.5%）,atypical autofluorescence in 6 eyes （10.2%）. In all the 63 eyes with local neurosensory retinal detachment,50 eyes （79.4%）showed abnor- mal autofluorescence on FAF images, including hypoautofluorescence in 15 eyes （30. 0% ）,hyperautofluorescence in 35 eyes （70.0%）;57 eyes （90.5%）showed abnor- mal autofluorescence on NIA images,including particles like hybrid autofluorescence in 51 eyes （89.5%）, hypoautofluorescence in 6 eyes （10.5%）. The neurosensory retinal detachment regions on 23 eyes （ 36.5% ） of FAF images and 33 eyes （52.4%） of NIA im- ages were more than that of FFA images. The normal regions showed on FFA images were found abnormal autofluorescence on NIA images in 3 eyes （4.8%）. Conclusion The FAF combined with NIA are useful to observe the RPE changes of chronic CSC.