非增生型糖尿病视网膜病变超广角眼底彩色照相与眼底自发荧光图像特征分析

Analysis of ultra-wide-field fundus fluorescein angiography and fundus autofluorescence imaging in nonproliferative diabetic retinopathy

目的分析非增生型糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)超广角眼底彩色照相与眼底自发荧光(fudus autofluorescence,FAF)的图像特征。方法使用欧堡全景200激光扫描检眼镜对40例(80眼)NPDR患者进行免散瞳模式下的超广角眼底彩色照相及FAF检查,对所有图像进行分析,得出两种模式下NPDR眼底改变的图像特征及阳性率。结果超广角眼底彩色照相和FAF的图像质量基本一致,均能反映周边部视网膜的情况。在各种典型的眼底病变中,极其微小的血管瘤以及点片状视网膜出血的显影在FAF上有增强,有助于细微病变的诊断。渗出在FAF上的显影并不明显,分辨率不够。视网膜新鲜性光凝斑在两种模式检查上均显影清晰,陈旧性光凝斑在FAF上易与出血混淆,应谨慎诊断。结论超广角眼底彩色照相图像清晰,周边部显示好,可以提供直观的视网膜图像;FAF可以观察到组织结构的细微改变及视网膜色素上皮细胞的代谢情况。两种模式相辅相成,能为NPDR的诊断、分期和治疗提供更好的帮助。

Objective To analyze image features of ultra-wide-field fundus fluorescein angiography and fundus autofluorescence(FAF) in patients with nonproliferative diabetic retinopathy (NPDR). Methods Totally 40 patients (80 eyes) who were diagnosed as NPDR respectively accepted ultra-wide-field fundus fluorescein angiography and FAF imaging using nonmydriatic optomap panoramic 200Tx,all images were analyzed to obtain imaging characteristics and positive rates. Results The image quality of ultra-wide-field fundus fluorescein angiography and FAF were much alike on peripheral retina.Imaging of tiny angioma and retinal hemorrhage were enhanced on FAF in different types of exemplary retinopathy,which contributed to the diagnosis of subtle lesions.Resolution of FAF was not adequate to diagnose retinal exudates.Recent photocoagulated spots were clearly displayed on both examinations,but prudent consideration for distant photocoagulated spots was recommended because they were not distinguishable from retinal hemorrhage. Conclusion Ultra-wide-field fundus fluorescein angiography displays clear imaging on peripheral retina and provides intuitive retinal images.FAF reveals subtle changes on retina,including metabolism of retinal pigment epithelial cells.These two modes complement each other and provide more advanced assistance for the diagnosis,stages and treatment of NPDR.