In-vivo mapping of drusen by fundus autofluorescence and spectral-domain optical coherence tomography imaging
In-vivo mapping of drusen by fundus autofluorescence and spectral-domain optical coherence tomography imaging
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DOI：
10.1007/s00417-015-3012-4
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发表时间：
2016-01-01
影响因子：
2.7
通讯作者：
Schmitz-Valckenberg, Steffen
中科院分区：
文献类型：
--
作者：
Goebel, Arno P.;Fleckenstein, Monika;Schmitz-Valckenberg, Steffen
目的通过光谱域光学相干断层扫描（SD-OCT）检测眼底可见黄斑变性（AMD）患者眼底自身荧光（FAF）信号的变化及相应的显微结构改变。方法回顾性分析22例AMD继发地理性萎缩（GA）患者30只眼，中位年龄74岁，年龄范围64 ~ 87岁，均行视网膜彩色眼底摄影（CFP）、FAF和SD-OCT （Spectralis HRA+OCT; Heidelberg Engineering GmbH，德国海德堡）。分析每只眼CFP上记录的GA近视区至少1个病灶（>= 63 μ m）。评估每个病灶部位的相对FAF强度和SD-OCT波段的变化。结果共分析73例患者，均存在FAF和SD-OCT的异质性相应改变。32例（44%）、27例（37%）、12例（16%）、2例（3%）患者FAF信号正常、升高、降低或不可测。覆盖在患者上的灶性高反射率在空间上最常局限于FAF增高（27例FAF增高患者中有9例（33%）存在）。外核层变薄和脉膜高反射率与FAF下降有关（12例FAF下降的患者中分别有7例[58%]和6例[50%]）。结论CFP上软性囊肿的出现不能区分保存完好的和明显受损的外视网膜完整性，包括细胞外视网膜色素上皮（RPE）沉积物上的早期萎缩和反射性的局灶性神经感觉改变。多模态成像显示了广谱的显微结构变化，这可能反映了德鲁森进化的不同阶段。
Purpose To determine fundus autofluorescence (FAF) signal variations and corresponding microstructural alterations on spectral-domain optical coherence tomography (SD-OCT) in areas of funduscopically visible drusen associated with age-related macular degeneration (AMD).Methods Thirty eyes from 22 patients with geographic atrophy (GA) secondary to AMD (median age 74, range 64-87 years), who had undergone retinal imaging including color fundus photography (CFP), FAF and SD-OCT (Spectralis HRA+OCT; Heidelberg Engineering GmbH, Heidelberg, Germany) were retrospectively analyzed. In each eye, at least one druse (>= 63 mu m) in the perilesional zone of GA recorded on CFP was analyzed. Relative FAF intensities and alterations in SD-OCT bands at the site of each druse were evaluated.Results A total of 73 drusen were analyzed, which were associated with heterogeneous corresponding alterations on FAF and SD-OCT. The FAF signal was normal, increased, decreased or not evaluable in 32 (44 %), 27 (37 %), 12 (16 %), and 2 (3 %) drusen, respectively. Focal hyperreflectivity overlying drusen was most frequently spatially confined to increased FAF (present in 9 (33 %) of 27 drusen with increased FAF). Outer nuclear layer thinning and choroidal hyperreflectivity were associated with decreased FAF (present in 7 [58 %] of 12 and 6 [50 %] of 12 drusen with decreased FAF, respectively).Conclusions The appearance of soft drusen on CFP does not allow for differentiation between preserved and markedly compromised outer retinal integrity, including incipient atrophy and focal neurosensory alterations of reflectivity overlying extracellular sub-retinal pigment epithelium (RPE) deposits. Multimodal imaging reveals a broad spectrum of microstructural changes, which may reflect different stages in the evolution of drusen.