Spontaneous remission of acute zonal occult outer retinopathy: follow-up using adaptive optics scanning laser ophthalmoscopy
Spontaneous remission of acute zonal occult outer retinopathy: follow-up using adaptive optics scanning laser ophthalmoscopy
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DOI：
10.1007/s00417-014-2760-x
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发表时间：
2015-06-01
影响因子：
2.7
通讯作者：
Ishibashi, Tatsuro
中科院分区：
文献类型：
--
作者：
Nakao, Shintaro;Kaizu, Yoshihiro;Ishibashi, Tatsuro
本研究的目的是报告一例急性区域性隐匿性外层视网膜病变 (AZOOR) 自发缓解的病例，并使用自适应光学扫描激光检眼镜 (AO-SLO) 进行随访。对一名诊断为 AZOOR 的 31 岁近视男性的右眼进行了随访。患者在首次就诊、1个月和2个月后接受了全面的眼科检查、频域光学相干断层扫描（SD-OCT）、多焦视网膜电图检查（mfERG）以及原型AO-SLO系统（佳能公司）成像。在该区域记录聚焦于感光层的图像，并创建 AO-SLO 图像的蒙太奇。患者右眼急性出现盲点和闪光。在 AO-SLO 上，第一次检查时，右眼可观察到局灶性暗区，但左眼未观察到（视锥细胞密度 8,589/mm(2)，视锥细胞感光细胞马赛克规律性 38.5%，视锥细胞间距 0.567）。 AO-SLO 上的暗区对应于 IS 的内节段和外节段 (IS/OS) 线或椭圆体中断的区域以及 mfERG 中的异常区域。 1、2个月后，症状逐渐消失，无需任何治疗。 IS/OS 线和 mfERG 几乎可以正常化。此外，在首次检查时可观察到一些局灶性黑斑的区域也可观察到正常的视锥细胞马赛克（视锥细胞密度10,112/mm（2），视锥细胞光感受器镶嵌规律性39.9％，视锥细胞间距0.606）。AO-SLO是AZOOR诊断和随访的有用工具。这项研究可能表明，在某些 AZOOR 病例中，可能会发生可逆性视锥细胞损伤并自发缓解。
The purpose of this study was to report a case of acute zonal occult outer retinopathy (AZOOR) with spontaneous remission that was followed up using adaptive optics scanning laser ophthalmoscopy (AO-SLO).The right eye of a 31-year old myopic man diagnosed with AZOOR was followed up. The patient underwent a full ophthalmologic examination, spectral-domain optical coherence tomography (SD-OCT), multifocal electroretinography (mfERG) and imaging with prototype AO-SLO systems (Canon Inc) at the first visit, 1 month after, and 2 months after. Images focused on the photoreceptor layer were recorded in the area, and a montage of AO-SLO images was created.The patient presented with acute onset of a blind spot and photopsia in his right eye. On AO-SLO, focal dark areas could be observed on the right eye but not on the left eye at the first examination (cone density 8,589/mm(2), mosaic regularity of cone photoreceptors 38.5 %, cone spacing 0.567). The dark areas on AO-SLO corresponded to areas of disrupted inner segments and outer segments (IS/OS) line or ellipsoid of the IS and abnormal area in mfERG. After 1 and 2 months, his symptoms tended to disappear gradually without any treatment. IS/OS line and mfERG could be nearly normalized. Furthermore, normal cone mosaic could be observed in areas where some focal dark spots could be observed at the first examination (cone density 10,112/mm(2), mosaic regularity of cone photoreceptors 39.9 %, cone spacing 0.606).AO-SLO is a useful tool of diagnosis and follow-up of AZOOR. This study might suggest reversible cone damage could occur in some cases of AZOOR with spontaneous remission.