Correlation of Fundus Autofluorescence with Spectral-Domain Optical Coherence Tomography and Vision in Diabetic Macular Edema
Correlation of Fundus Autofluorescence with Spectral-Domain Optical Coherence Tomography and Vision in Diabetic Macular Edema
复制标题
DOI：
10.1016/j.ophtha.2011.11.018
复制
发表时间：
2012-05-01
期刊：
影响因子：
13.7
通讯作者：
Kim, Hyung Chan
中科院分区：
文献类型：
--
作者：
Chung, Hyewon;Park, Byeongjun;Kim, Hyung Chan
目的：探讨糖尿病性黄斑水肿（DME）患者眼底自发荧光（FAF）与光谱域光学相干断层扫描（SD-OCT）结果以及视力（VA）之间的相关性，并确定其视觉预后因素。设计：回顾性，干预性病例系列。参与者：61例首次接受玻璃体内注射贝伐单抗（IVB）治疗的DME患者。在IVB之前和之后（IVB之前和之后）获得VA和FAF的评估以及SD-OCT图像。以1至4的量表对中心凹FAF分级。主要观察指标：FAF与视力及SD-OCT结果的相关性，包括黄斑中心厚度（CMT）、外核层厚度、外界膜完整性（ELM）、感光细胞内外段连接完整性（IS/OS）。更好的VA、ELM的保留和IVB前的IS/OS与IVB后更好的VA相关。在DME的类型中，黄斑囊样水肿与小凹处FAF增加显著相关。一个更高水平的FAF是5.6倍，更有可能发生在DME与一个缺陷，在IS/OS和10倍，更有可能发生与每10 μ m的CMT增加。IVB前最小分辨角（logMAR）的对数每增加0.1倍，高FAF的概率增加1.73倍。尽管存在重度DME，但与IVB前存在重度DME的高水平FAF的患眼相比，低水平FAF的患眼表现出IS/OS缺损和较大logMAR VA的数量较少。随访期间视力下降的患者IVB前FAF的平均等级高于视力增加或保持良好视力的患者。DME患者FAF与SD-OCT参数和VA的强相关性有助于预测感光细胞完整性的恢复和随后的视力恢复，特别是在重度DME患者中，即使用SD-OCT也不能充分评价治疗前的感光体完整性。
Purpose: To investigate the correlation between fundus autofluorescence (FAF) and the results of spectral-domain optical coherence tomography (SD-OCT) as well as visual acuity (VA) in patients with diabetic macular edema (DME) and to determine the visual prognostic factors.Design: Retrospective, interventional case series.Participants: Sixty-one patients with DME who underwent intravitreal injection of bevacizumab (IVB) as their first treatment.Methods: An assessment of VA and FAF and SD-OCT images were obtained before and after IVB (pre- and post-IVB). Foveal FAF was graded on a scale of 1 to 4. The presence or absence of FAF at the foveola was also determined.Main Outcome Measures: The association of FAF with VA and the SD-OCT results, including central macular thickness (CMT), outer nuclear layer thickness, the integrity of the external limiting membrane (ELM), and the integrity of the junction between the inner and outer segment of the photoreceptor (IS/OS).Results: Better VA, preservation of the ELM, and IS/OS pre-IVB were associated with better VA post-IVB. Of the types of DME, cystoid macular edema significantly correlated with increased FAF at the foveola. A higher level of FAF was 5.6 times more likely to occur in DME with a defect in IS/OS and 10 times more likely to occur with each 10-mu m increase in CMT. Each increase by a factor of 0.1 in the logarithm of the minimum angle of resolution (logMAR) pre-IVB increased the probability of high FAF by a factor of 1.73. Despite severe DME, fewer eyes with a low level of FAF exhibited an IS/OS defect and large logMAR VA than eyes with a high level of FAF with severe DME pre-IVB. The average grade of FAF pre-IVB was higher in patients with decreased vision during follow-up than in patients with increased or unchanged good vision.Conclusions: The strong association of FAF with SD-OCT parameters and VA in patients with DME could aid in the prediction of the restoration of photoreceptor integrity and subsequent visual recovery, especially in patients with severe DME, in whom photoreceptor integrity before treatment could not be adequately evaluated, even with SD-OCT.