Changes of fundus autofluorescence and spectral-domain optical coherence tomographic findings after treatment of primary intraocular lymphoma.
Changes of fundus autofluorescence and spectral-domain optical coherence tomographic findings after treatment of primary intraocular lymphoma.
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DOI：
10.1186/1869-5760-4-7
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发表时间：
2014-02-22
影响因子：
2.9
通讯作者：
Naito T
中科院分区：
文献类型：
--
作者：
Egawa M;Mitamura Y;Hayashi Y;Semba K;Naito T
我们报告眼底自发荧光（FAF），光谱域光学相干断层扫描（SD-OCT），微视野和多焦视网膜电图（mfERG）的结果之前，期间，成功治疗原发性眼内淋巴瘤（PIOL）。一名57岁男性左眼有经活检证实的PIOL，他接受了8个月的玻璃体内甲氨蝶呤注射治疗。治疗前，眼底检查发现许多小的，黄色的病变，边界清晰的眼底后，成为萎缩9个月后，首次治疗。FAF在治疗前表现为颗粒状低自体荧光和高自体荧光，在治疗后表现为与视网膜色素上皮（RPE）萎缩相对应的斑片状低自体荧光。SD-OCT显示RPE水平和以上的结节性增加，Bruch膜与RPE分离，RPE部分损伤，感光细胞内段/外段（IS/OS）连接中断，内层视网膜中的多个超反射信号，中心凹变薄和视网膜旁增厚。治疗后，视网膜内层高反射性浸润明显减少，RPE和IS/OS连接得到恢复。中心凹变薄和视网膜旁增厚消退，中央脉络膜厚度降低。在随访期间，mfERG仍然降低。相比之下，微视野检查显示视网膜灵敏度部分改善。FAF和SD-OCT是评价PIOL治疗前后视网膜和脉络膜变化的有效无创方法。我们的研究结果表明，视力恢复后，成功的治疗可能是有限的，一旦黄斑浸润。
We report the fundus autofluorescence (FAF), spectral-domain optical coherence tomographic (SD-OCT), microperimetric, and multifocal electroretinographic (mfERG) findings before, during, and after successful treatment of a primary intraocular lymphoma (PIOL). A 57-year-old man had biopsy-proven PIOL in his left eye, and he was treated with intravitreal methotrexate injections for 8 months. Before treatment, fundus examination disclosed many small, yellow lesions with distinct boundaries in the posterior fundus which became atrophic 9 months after the initial treatment. FAF showed a pattern of granular hypoautofluorescence and hyperautofluorescence before the treatments and patchy hypoautofluorescence corresponding to retinal pigment epithelial (RPE) atrophy after the treatments. SD-OCT showed increased nodularity at the level of and above the RPE, a separation of Bruch membrane from the RPE, partial damage of the RPE, disruption of the photoreceptor inner segment/outer segment (IS/OS) junction, multiple hyperreflective signals in the inner retina, foveal thinning, and parafoveal thickening. After treatment, the hyperreflective infiltrations in the inner retina were markedly decreased, and the RPE and IS/OS junction were restored. The foveal thinning and parafoveal thickening resolved, and the central choroidal thickness decreased. During the follow-up, the mfERGs remained decreased. In contrast, microperimetry showed a partial improvement of the retinal sensitivity. FAF and SD-OCT are useful noninvasive methods to evaluate the retinal and choroidal changes before and after treatment of PIOL. Our results suggest that visual recovery after successful treatment may be limited once macula is infiltrated.