摘要
目的 观察多发性一过性白点综合征（MEWDS）患者的多种眼底影像特征。方法 回顾性病例研究。临床检查确诊的MEWDS患者11例11只眼纳入研究。其中，男性1例1只眼，女性10例10只眼；年龄15～41岁，平均年龄27.6岁。出现症状至就诊时间为2～13 d，出现症状至就诊的平均时间为4.7 d。所有患者均行最佳矫正视力、裂隙灯显微镜、间接检眼镜、眼底彩色照相、眼底自身荧光（AF）、荧光素眼底血管造影（FFA）、吲哚青绿血管造影（ICGA）、频域光相干断层扫描（SD-OCT）检查。平均随访时间3.2个月。观察病灶的彩色眼底像、AF、FFA、ICGA、OCT特征。结果 所有患眼黄斑区均可见橘红色颗粒样改变；AF表现为后极部边界模糊融合成片的强AF；FFA表现为早期病灶呈细针尖样花环状排列的强荧光，晚期荧光素染着；ICGA表现为晚期病灶呈边界不清、融合成片的弱荧光；SD-OCT表现为黄斑中心凹处视网膜色素上皮（RPE）层强反射物质堆积伴椭圆体区等结构改变，病灶处交叉区及椭圆体区结构紊乱。结论 MEWDS患眼黄斑区呈橘红色颗粒样改变；呈不均匀弥漫性强AF；FFA 早期表现为细针样花环状排列边界不清的强荧光；ICGA晚期呈小片状融合的弱荧光病灶；SD-OCT表现为黄斑中心凹RPE表面强反射物质堆积，病灶处椭圆体区结构紊乱。
Objective To observe the characteristics of multiple evanescent white dot syndrome （MEWDS） with modern multimodal imaging modalities. Methods This was a retrospective case study. Eleven patients （11 eyes） diagnosed with MEWDS were enrolled. There were 10 females and 1 male, mean age was 27.6 years （range 15 - 41 years）. The period between disease onset and visiting to the hospital was between 2 to 13 days, the average time was 4.7 days. All the patients underwent examinations of best corrected visual acuity, slit-lamp biomicroscope, indirect ophthalmoscope, fundus color photography, fundus autofluorescence （FAF）, fundus fluorescein angiography （FFA）, indocyanine green angiography （ICGA） and spectral domain optical coherence tomography （SD-OCT）. The mean follow up duration was 3.2 months. The imaging characteristics were compared. Results Fundus color photography showed foveal orange-red granularity in all eyes. FAF showed strong autofluorescence with a vague boundary. FFA showed a variable number of highly fluorescent fine needle-like dots arranged in a ring in the early stage, and fluorescence remained in the late stage. ICGA showed advanced lesions of vague boundary merged into a large plaque of deep retinal hypofluorescence. SD-OCT showed the hyperreflectant material deposit over the retinal pigment epithelium and extending anteriorly through the interdigitation zone, ellipsoid layer, and toward the external limiting membrane. At the site of extrafoveal lesions, SD-OCT revealed the presence of discontinuities or disruptions centered on the ellipsoid zone to include the interdigitation. Conclusions In MEWDS patients, fundus photography showed foveal orange-red granularity; FFA showed early fluorescent dots distributed in a ring pattern; ICGA showed hypofluorescent lesions in the later stage; SD-OCT showed disruption of the interdigitation zone and ellipsoid zone and accumulations of hyperreflective material that was of variable size and shape; FAF showed strong autofluoresce areas that correlated to spots observed with FFA and ICGA.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2016年第3期257-260,共4页
Chinese Journal of Ocular Fundus Diseases
