伴发视网膜下出血的脉络膜破裂患者短波长眼底自发荧光及近红外眼底自发荧光的特征

The features of short-wave length fundus autofluorescence and near-infrared fundus autofluorescence on patients with choroidal rupture associated with sub-retinal hemorrhage

目的：分析因眼球挫伤导致的脉络膜破裂伴视网膜下出血患者的短波长眼底自发荧光（ SW-FAF）和近红外眼底自发荧光（ NIR-FAF）的特征。方法对38例因眼球挫伤导致脉络膜破裂者,共计40只眼,于伤后15 d内进行眼底彩色照相（ CFP）、SW-FAF及NIR-FAF检查。结果 CFP显示该40只眼（100%）有视网膜下出血,其中,29只眼（72.50%）的脉络膜破裂灶在CFP及SW-FAF图像上可被分辨。另外11只眼（27.50%）,因脉络膜破裂灶被出血遮盖而不能在CFP及SW-FAF图像上显现。在SW-FAF图像上,视网膜下出血及脉络膜破裂处均呈现边界清晰的低荧光。在NIR-FAF图像上,虽然视网膜下出血导致荧光亮度减弱,但因脉络膜破裂产生的荧光暗区在40只患眼（100.00%）均清晰可见。结论 NIR-FAF在观察视网膜下出血遮盖的脉络膜破裂方面具有独特的优越性,这项技术可用于诊断因眼球挫伤导致的脉络膜破裂及评估预后。

Objective To analyse the features of images of short-wave length fundus autofluorescence （ SW-FAF ） and near-infrared fundus autofluorescence （ NIR-FAF ） on patients with choroidal rupture associated with sub-retinal hemorrhage after ocular contusion. Methods Forty eyes of 38 cases with choroidal rupture after ocular contusion were collected. They had undergone color fundus photography （ CFP） , SW-FAF and NIR-FAF examination within 15 days after trauma. Results The CFP revealed sub-retinal hemorrhage in all 40 eyes （100. 00%）. In 29 eyes （72. 5%）, choroidal ruptures could be seen on images of CFP and SW-FAF . In 11 eyes （27. 5%）, choroidal ruptures could not be found by CFP or SW-FAF. The lesion was blocked by sub-retinal hemorrhage. On images of SW-FAF, sub-retinal hemorrhage and choroidal ruptures presented as hypo-FAF with sharp margin. On images of NIR-FAF, although sub-retinal hemorrhage abated the brightness of FAF, the circumscribed hypo-FAF induced by choroidal ruptures was still obvious in the 40 eyes （100%）. Conclusion NIR-FAF has unique superiority in detecting choroidal rupture covered by sub-retinal hemorrhage. This technique may contribute to the diagnosis and prognosis evaluating of choroidal rupture after ocular contusion.