多发性一过性白点综合征的眼底自发荧光观察

The fundus autofluorescence of the multiple evanescent white dot syndrome

目的探讨多发性一过性白点综合征（MEWDS）患者的眼底自发荧光（FAF）特征。方法回顾性系列病例研究。对2009年1月至2010年12月期间在河北省邢台市眼科医院检查并确诊为MEWDS的8例（8只眼）患者的临床资料进行分析。其中男性3例，女性5例；年龄19～48岁，平均33岁。就诊至发病时间为2～12d，平均6．5d。采用共焦激光扫描仪同步眼底血管造影模式对所有患者进行彩色眼底照相、FAF、荧光素眼底血管造影（FFA）和吲哚氰绿血管造影（ICGA）检查，应用488nm、787nm两种波长的激光，同时获得脂褐素和黑色素相关的两种自发荧光，对比观察不同时期动态影像学表现，重点观察患眼眼底白色斑点在自发荧光照相中的改变特征。结果FAF。‰。检查结果显示，所有患眼眼底的灰白色斑点状病灶均呈边界欠清楚的斑片状强自发荧光；FAF检查结果显示无明显异常改变。FAF4。图像与彩色眼底图像中的灰白色斑点、FFA中的强荧光灶及ICGA后期的弱荧光灶在分布上基本对应。病变痊愈后，FAF4。图像中的强自发荧光灶也能完全恢复。结论MEWDS眼底上的斑点状病灶在FAF4。中呈强白发荧光像，是其特征性自发荧光改变。

Objective To observe the imaging features of fnndus autofluorescence （FAF） in patients with multiple evanescent white dot syndrome （MEWDS）. Methods Retrospective case-series study. Eight cases of MEWDS patients visited Xingtai eye hospital between January 2009 and December 2010 were included in this study. Three males and 5 females, aged from 19 to 48 years, mean age was 33 years old. The span between onset and visit to the hospital was between 2 to 12 days, the average time was 6.5 days. All the patients underwent comprehensive ophthalmic examination and fundus color photography, FAF, fluorescein angiography（ FFA ） , indocyanine green angiography（ICGA） by HRA-2. Two different spectrums of autofluorescence excited by laser of 488 nm and 787 nm were recorded, which were related to lipofuscin and melanin respectively. Dynamic imaging changes in different stages were observed and compared. The autofluoresce of fundus with white dot was paid extra attention. Results The white dots in 8 eyes showed strong autofluorescence with a vague boundary in the FAF image excited by laser of 488 nm but normal autofluorescence under the FAF7s7 nm＂ The strong autofluorescence of 488 nm agreed with the white dots in the fundus photograph, hyperfluorescence lesions in FFA and the hypofluorescence focus in the later stage of ICGA. After the disease cured,the hyperfluorescence lesions in FFA also faded. Conclusions The fundus autofluorescence features of patients with MEWDS are hyperfluorescence in the site of white dots in FAF4m. It is the characteristic chan^e of this disease.