Novel optical coherence tomography classification of torpedo maculopathy
Novel optical coherence tomography classification of torpedo maculopathy
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DOI：
10.1111/ceo.12435
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发表时间：
2015-05-01
影响因子：
4
通讯作者：
Chen, Fred K.
中科院分区：
文献类型：
--
作者：
Wong, Evan N.;Fraser-Bell, Samantha;Chen, Fred K.
背景：鱼雷黄斑病变是一种罕见的疾病，具有双重临床意义。首先，它是一种不典型先天性视网膜色素上皮肥大的鉴别诊断。其次，视野丧失已被报道。我们展示了在光学相干断层扫描上看到的鱼雷黄斑病变的结构异常光谱，并将其与呈现年龄、眼底自身荧光、视网膜灵敏度丧失和视野异常联系起来。设计：回顾性观察性病例系列。参与者：2008年至2013年期间见过的五名澳大利亚患者。方法眼底摄影、光学相干层析成像、眼底自体荧光和视野分析。1例患者行荧光素血管造影。主要观察指标病变在各成像方式上的表现及视野分析。结果我们一致观察到一个平坦的，位于颞黄斑的低色素病变，有一个独特的尖端指向中央窝。光学相干断层扫描显示不同的视网膜脉络膜特征，从轻度视网膜外障碍（1型）到视网膜外空化（2型）。短波自身荧光显示不同程度的低自身荧光。在两例患者中进行了近红外自体荧光，显示了一个明确的次自体荧光区域。显微镜观察显示，一名患者病变敏感性正常，另一名患者病变颞部有密集的中央旁暗点。在汉弗莱现场分析中，两名患者中只有一名患有中心旁暗斑。结论两种类型的鱼雷黄斑病变具有独特的光学相干断层扫描、人口学特征、眼底自身荧光和视网膜敏感性特征。这些可能代表了同一种疾病在几十年里演变的不同阶段。
BackgroundTorpedo maculopathy is a rare condition with a twofold clinical significance. Firstly, it is a differential of atypical congenital hypertrophy of the retinal pigment epithelium. Secondly, visual field loss has been reported. We demonstrate the spectrum of structural abnormality of torpedo maculopathy as seen on optical coherence tomography, and correlate this with age of presentation, fundus autofluorescence, retinal sensitivity loss and visual field abnormality.DesignA retrospective, observational case series.ParticipantsFive Australian patients seen between 2008 and 2013.MethodsFundus photography, optical coherence tomography, fundus autofluorescence and visual field analysis. One patient underwent fluorescein angiography.Main Outcome MeasuresLesion appearance on each imaging modality, and visual field analysis.ResultsWe consistently observed a flat, hypopigmented lesion located in the temporal macula, with a distinctive tip pointing toward the fovea. Optical coherence tomography demonstrated variable retinochoroidal features ranging from mild outer retinal disturbance (type 1) to outer retinal cavitation (type 2). Lesion appearance on short-wave autofluorescence showed varying degrees of hypo-autofluorescence. Near-infrared autofluorescence was performed in two patients and showed a well-defined region of hypo-autofluorescence. Microperimetry showed normal sensitivity over the lesion in one patient and a dense paracentral scotoma over the temporal portion of the lesion in another. On Humphrey field analysis, only one of two patients tested had a paracentral scotoma.ConclusionTwo types of torpedo maculopathy lesions are described here with unique optical coherence tomography, demographic, fundus autofluorescence and retinal sensitivity features. These may represent different stages of the same disease that evolve over several decades.