急性区域性隐匿性外层视网膜病变的影像学观察

Imaging observation of acute zonal occult outer retinopathy

目的观察急性区域性隐匿性外层视网膜病变（acute zonal occult outer retinopathy，AZOOR）患者的眼底红外照相（Infrared Ray，IR）、自发荧光（autofluorescence，AF）、红外自发荧光（IRAF）、荧光素眼底血管造影（FFA）和吲哚青绿血管造影（ICGA）同步检查、光相干断层扫描（OCT）的影像学特征。方法回顾性的观察2012年11月至2013年11月在河北省眼科医院确诊为AZOOR共12例患者的眼底IR、AF、IRAF、FFA、ICGA、OCT检查结果，观察各图像特征。结果12只患眼IR均无明显改变；12只患眼AF显示病变区域为边界清晰的强自发荧光；12只患眼IRAF未见明显改变；2只患眼FFA未见明显异常，10只患眼FFA早中期未见明显异常，晚期见病变区域视网膜呈轻微强荧光；12只患眼ICGA早期及中期无明显改变，晚期ICGA反转后病变区域为边界清晰的低荧光。OCT显示2例病变区域未见明显异常。10例病变区域视网膜光感受器细胞内外连接带（IS/OS层）反光减弱，部分缺失。结论AZOOR确诊后，可以应用自发荧光及OCT观察疾病的变化，避免有创损害；在没有ICGA的条件下，对眼底改变不明显的病人进行自发荧光照相，可以避免漏诊。

Objective To observe the characteristics of acute zonal occult outer retinopathy by the infrared photography （IR）, Autofluorescence （AF）, Infrared Ray Autofluorescence （IR AF）, Fundus Fluoresce Angiography （FFA）, Indocyanine Green Angiography （ICGA）, optical coherence tomography （OCT）. Methods Retrospective observe 12 diagnosed AZOOR cases with IR, AF, IR AF, FFA, ICGA, OCT examination results, find the image feature. Results Twelve eyes had no obvious change in IR; 12 eyes displayed the lesion with clear boundary for strong autofluorescence; 12 eyes had no obvious change in IR AF; 2 eyes had no obvious abnormalities in FFA, 10 eyes had no obvious abnormalities in early and middle FFA, In the late period, the lesion region of the retina showed a slight strong fluorescence; 12 eyes had no obvious change at the early and middle ICGA, In the late period of ICG imaging, after the contrast reversal the lesion was low fluorescence with clear boundary. OCT showed that there was no obvious abnormality in 2 cases, 10 cases showed the inner and outer retinal photoreceptor cells of the regional lesions reflecting weakening, partial de- letion. Conclusions After the AZOOR confn＇med, spontaneous fluorescence and OCT can be used to observe the disease changes to avoid the damage check. The spontaneous fluorescence photography can be used for the patients whose fnndus change is not obvious if the at the condition without ICGA to avoid missed diagnosis.