视网膜色素上皮挫伤的眼底自发荧光改变

Changes of the fundus autoflurescence in eyes of blunt traumatic injuries

目的观察视网膜色素上皮挫伤时的眼底自发荧光（AF）形态改变，探讨AF检查对眼外伤造成的视网膜色素上皮挫伤的诊断意义。方法对31例（36只眼）视网膜色素上皮挫伤的的患者，进行眼底自发荧光检查。采用海德堡激光眼底扫描系统获取自发荧光图像。与同病例的眼底检查及FFA做对比分析，得出其自发荧光特征。结果所有病例在视网膜色素上皮挫伤区域的自发荧光普遍弥漫性增强，有色素上皮增生处大多表现为更强的自发荧光点，色素脱失处大多表现为低荧光，在总体增强区域表现为地图状的自发荧光。结论眼球钝挫伤早期导致的视网膜色素上皮的损害会引起相应的自发荧光的改变，主要以自发荧光增强为主，反映该区域色素上皮高代谢状态或增殖活动为主，弱的AF较少，表明挫伤后短期局部的色素上皮萎缩。这些改变与一些以萎缩性病变为主的眼底病的AF有明显区别，因而AF应用于视网膜色素上皮挫伤的诊断有明显的意义。

Objective To observe the changes of the autoflurescence （AF）in eyes of blunt traumatic injuries,to study the signification of the AF in diagnosis of RPE contusion.Methods AF images and fimdus fluorescence angiography （FFA）images were obtained from 36 eyes of 31 patients with retinal pigment epithelial （RPE）contusion with Heidelberg HRA-II.Contrasting the AF images, FFA images and fundus finds with ophthalmoscopy to find out the characteristics of the AF in RPE contusion.Results All cases in the RPE Confusion area AF generally enhanced diffusely, stronger AF dots showed in the RPE hyperplasic a area, and lower AF showed in the RPE atrophy area.Conclusion RPE damage caused by early ocular blunt trauma can cause a corresponding AF changes.It＇ s mainly enhancement olAF due to the high metablic state or proliferative activity of RPE in the area,while weak fluorescence indicated short-term and local RPE atrophy after oculcr blunt trauma.