眼底自发荧光应用于后葡萄膜炎的观察研究

The Observational Study of Fundus Autofluorescence Applied to Posterior Uveitis

摘要: 目的：眼底自发荧光(fundus autofluorescence, FAF)技术是近年来应用到临床的一项视网膜影像学技术，其可用于快速、无创地诊断和监测包括后葡萄膜炎在内的很多眼底疾病。本文将探讨FAF在后葡萄膜炎的影像特征及其临床应用价值。方法回顾性分析9例(15只眼)后葡萄膜炎患者的临床资料，分别行FAF、光学相干断层扫描(optical coherence tomography, OCT)、荧光素钠眼底血管造影(fundus fluorescence angiography, FFA)或吲哚青绿脉络膜血管造影(indocyanine green angiography, ICGA)等检查，对比FAF与眼底血管造影(FFA或ICGA)在监测黄斑水肿中的效果分析；对比后葡萄膜炎治疗前后眼底自发荧光的表现并进行评价分析。结果：1) 9例(15眼)后葡萄膜炎患者行FAF检查显示12只眼黄斑区呈范围大小不一的异常强荧光，而FFA/ICGA检查显示其中9眼黄斑区呈强荧光积存，同时OCT检查显示其中10眼黄斑区神经上皮层均有不同程度隆起增厚。2) 9例(15眼)后葡萄膜炎患者在治疗前后患眼视力有不同程度提高或保持不变(11眼视力不同程度提高，4眼视力保持不变)，其相应FAF检查显示异常高荧光减弱，范围稍有缩小，同时异常低荧光区域不变或稍有扩大。结论：FAF在评估后葡萄膜炎黄斑水肿及评价后葡萄膜炎治疗前后疗效分析等方面具有简单无创、临床应用性强且随访性强的特殊应用价值。

Abstract: Objective: Fundus autofluorescence is a new developed technique in opthalmoscopic imaging in recent years. It can monitor and diagnose various kinds of fundus diseases including posterior uveitis quickly and noninvasively. In this paper, we discussed the image feature and clinical ap-plication about fundus autofluorescence in posterior uveitis. Methods: We retrospectively analyzed 9 patients (15 eyes) suffering from posterior uveitis, and some eximanations were given to all of the patients, such as fundus autofluorescence (FAF), optical coherence tomography (OCT), fundus fluorescence angiography (FFA) or indocyanine green angiography (ICGA). First, we compared FAF with FFA or ICGA in evaluating macular edema; then we observed and analysed treatment effect by comparing manifestations before and after the treatment for posterior uveitis in FAF. Results: 1) 12 eyes of 9 patients (15 eyes) suffering from posterior uveitis show abnormal high fluorescence with irregular size in FAF. However, 9 eyes of them show high fluorescence in FFA or ICGA. Meanwhile, 10 eyes show that their retinal neurosensory layer in fovea thickens obviously in OCT. 2) The eyesight of 9 patients (15 eyes) suffering from posterior uveitis improves varying degrees or remains unchanged (the eyesight of 11 eyes improves and 4 of them remain unchanged), and their corresponding FAF expression shows that the intensity and extent of abnormal high fluorescence both reduce; the extent of low fluorescence remains unchanged or extends a little. Conclusions: There are special applications for FAF to evaluate macular edema and estimate treatment effect for posterior uveitis. Other than greater compliance with follow-up, it’s also non-invasive and easy to operate.