High-Resolution Photoreceptor Imaging in Idiopathic Macular Telangiectasia Type 2 Using Adaptive Optics Scanning Laser Ophthalmoscopy
High-Resolution Photoreceptor Imaging in Idiopathic Macular Telangiectasia Type 2 Using Adaptive Optics Scanning Laser Ophthalmoscopy
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DOI：
10.1167/iovs.11-7251
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发表时间：
2011-07-01
影响因子：
4.4
通讯作者：
Yoshimura, Nagahisa
中科院分区：
文献类型：
--
作者：
Ooto, Sotaro;Hangai, Masanori;Yoshimura, Nagahisa
目的.应用自适应光学扫描激光检眼镜（AO-SLO）研究特发性黄斑毛细血管扩张症（MacTel）2型患者光感受器的病理改变。13只非增殖性MacTel 2型和10只正常眼进行了全面的眼科检查，光谱域光学相干断层扫描（SD-OCT），并与原始原型AO-SLO系统成像。所有MacTel 2型患眼均行荧光素血管造影（FA）、眼底自发荧光（FAF）、共焦蓝光反射（CBR）和眼底监测微视野（MP）检查。所有MacTel 2型患眼在AO-SLO图像上都有环状暗区和/或小斑片状区域;在距中心凹中心0.5 mm处，每个半球的视锥密度显著低于正常眼; CBR中的旁反射面积大于FA中的高荧光面积、FAF增加的面积、AO-SLO上的暗区和MP上的视网膜敏感性降低的面积。AO-SLO上的暗区大致对应于FA中的渗漏区，但是在11只眼睛中，在没有FA渗漏的区域中也观察到暗区，包括具有最早MacTel临床体征的眼睛。视敏度和视网膜敏感度与距中心凹0.5 mm处的平均视锥密度相关。在MacTel 2型眼中，AO-SLO显示了与视力下降相关的视锥镶嵌中的独特暗区和视锥密度降低，即使在具有正常血管的区域中，这表明该特征代表了与MacTel 2型发病机制相关的早期神经元变化。（Invest Ophthalmol维斯科学。2011; 52：5541-5550）DOI：10.1167/iovs.11-7251
PURPOSE. To study pathologic changes in the photoreceptors in eyes with idiopathic macular telangiectasia (MacTel) type 2 using adaptive optics scanning laser ophthalmoscopy (AO-SLO).METHODS. Thirteen eyes with nonproliferative MacTel type 2 and 10 normal eyes underwent a full ophthalmologic examination, spectral-domain optical coherence tomography (SD-OCT), and imaging with an original prototype AO-SLO system. All eyes with MacTel type 2 were examined with fluorescein angiography (FA), fundus autofluorescence (FAF), confocal blue reflectance (CBR), and fundus-monitoring microperimetry (MP).RESULTS. All eyes with MacTel type 2 had ring-like dark areas and/or small patchy regions on AO-SLO images; significantly lower cone density than that of normal eyes in each hemisphere at 0.5 mm from the foveal center; an area with parafoveal reflectance in CBR that was larger than the hyperfluorescence area in FA, the area of increased FAF, the dark areas on AO-SLO, and the area of decreased retinal sensitivity on MP. Dark areas on AO-SLO roughly corresponded to the leakage area in FA, but dark areas were also seen in areas without FA leakage in 11 eyes, including an eye with the earliest clinical signs of MacTel. Visual acuity and retinal sensitivity correlated with mean cone density 0.5 mm from the center of the fovea.CONCLUSIONS. In eyes with MacTel type 2, AO-SLO revealed unique dark regions in the cone mosaic and decreased cone density that was associated with decreased vision, even in areas with normal vasculature, which suggests that this feature represents early neuronal changes involved in the pathogenesis of MacTel type 2. (Invest Ophthalmol Vis Sci. 2011; 52: 5541-5550) DOI: 10.1167/iovs.11-7251