Blue light and near-infrared fundus autofluorescence in acute Vogt–Koyanagi–Harada disease
Blue light and near-infrared fundus autofluorescence in acute Vogt–Koyanagi–Harada disease
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DOI：
10.1136/bjo.2009.164665
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发表时间：
2009-12
影响因子：
4.1
通讯作者：
H. Koizumi;K. Maruyama;S. Kinoshita
中科院分区：
文献类型：
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作者：
H. Koizumi;K. Maruyama;S. Kinoshita
目的探讨急性Vogt-Koyanagi-Harada（VKH）病眼底自发荧光（FAF）的特点。方法应用共焦扫描激光检眼镜对5例10眼青光眼患者治疗前后进行蓝光和近红外光FAF摄影。FAF图像随访6个月，并与其他成像方式进行回顾性比较。结果2例患者4眼均表现为黄斑部轻度均匀的高自体荧光，浆液性视网膜脱离区伴有低自体荧光。在立即静脉注射大剂量类固醇治疗后，异常的FAF在6个月时恢复正常。其他六个眼睛的三名患者，谁提出的症状后几周，最初表现出弥漫性和斑驳的高自发荧光后极，混合低自发荧光引起的浆液性视网膜脱离在四只眼睛。静脉注射高剂量类固醇治疗后，所有6只眼睛均显示分散和广泛的高自体荧光，逐渐变得明显并集中在黄斑，部分导致6个月时出现一些低自体荧光点。BL-FAF和NIR-FAF显示出相似的FAF模式，但NIR-FAF更明显。结论FAF成像可无创性地观察急性VKH时视网膜色素上皮（RPE）的代谢和功能变化。结果表明，早期和充分的高剂量类固醇治疗可能会预防持续性RPE损伤。此外，NIR-FAF可以作为早期检测RPE异常的替代方法。
Background/aims To investigate the characteristics of fundus autofluorescence (FAF) in acute Vogt–Koyanagi–Harada (VKH) disease. Methods FAF photography with blue light (BL-FAF) and near-infrared light (NIR-FAF) was performed on 10 eyes of five patients using a confocal scanning laser ophthalmoscope before and after treatment. The FAF images were followed for 6 months and retrospectively reviewed with comparisons of the other imaging modalities. Results At presentation, four eyes of two patients who presented soon after the initial ocular symptoms showed mild and uniform hyperautofluorescence in the macula mixed with hypoautofluorescence in the areas of serous retinal detachment. After immediate treatment with an intravenous high-dose steroid, the abnormal FAF returned to normal at 6 months. The other six eyes of three patients, who presented weeks after the symptoms, initially demonstrated diffuse and mottled hyperautofluorescence over the posterior pole, mixed with hypoautofluorescence induced by serous retinal detachment in four eyes. After treatment with an intravenous high-dose steroid, all six eyes showed scattered and widespread hyperautofluorescence, which gradually became evident and concentrated in the macula, partially resulting in some hypoautofluorescent dots at 6 months. The BL-FAF and the NIR-FAF demonstrated similar FAF patterns, but more evidently in NIR-FAF. Conclusion FAF photography non-invasively visualised sequential metabolic and functional changes in the retinal pigment epithelium (RPE) in acute VKH disease. The results suggest that early and sufficient treatment with a high-dose steroid might prevent persistent RPE damage. In addition, NIR-FAF can be an alternative method for the early detection of RPE abnormality.