Detection of airbag impact-induced cone photoreceptor damage by adaptive optics scanning laser ophthalmoscopy: a case report.
Detection of airbag impact-induced cone photoreceptor damage by adaptive optics scanning laser ophthalmoscopy: a case report.
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DOI：
10.1186/s12886-016-0275-4
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发表时间：
2016-07-08
影响因子：
2
通讯作者：
Ishibashi T
中科院分区：
文献类型：
--
作者：
Kaizu Y;Nakao S;Yamaguchi M;Murakami Y;Salehi-Had H;Ishibashi T
本研究的目的是报告一例使用自适应光学扫描激光检眼镜 (AO-SLO) 进行安全气囊展开撞击后出现外伤性黄斑病变并伴有中央视野缺损的病例。一名51岁男子遭遇车祸，左眼被展开的安全气囊击中，导致出现中央暗点。受伤后 14 个月和 22 个月，患者接受了全面的眼科检查、频域光学相干断层扫描 (SD-OCT) 以及原型 AO-SLO 系统（佳能公司）的成像。在中央凹区域记录聚焦于感光层的图像，并创建 AO-SLO 图像的蒙太奇。在 AO-SLO 上，受伤后 14 个月可以在左眼中观察到局灶性暗区。分析表明，与同一眼的正常区域（视锥密度，24821/mm2；六边形Voronoi域比例，44.1%；平均最近邻距离（NND）/期望NND，0.606）相比，视锥镶嵌（视锥密度，16503/mm2；六边形Voronoi域比例，36.3%；平均最近邻距离（NND）/预期NND，0.606）是无序的。 NND/预期 NND，0.739）。锥体缺陷区域对应于暗点区域。受伤后 22 个月对患者进行了第二次 AO-SLO，尽管仍有锥体反射率降低的区域，但此时 AO-SLO 检测到锥体马赛克的部分改善。闭合性眼球钝性眼外伤后受损的视锥细胞的部分恢复可以使用 AO-SLO 纵向跟踪来记录。
The purpose of this study was to report a case of traumatic maculopathy with para-central visual field defects following an impact by airbag deployment using adaptive optics scanning laser ophthalmoscopy (AO-SLO). A 51-year-old man was involved in a motor vehicular accident and his left eye was struck by the deployed airbag, resulting in a para-central scotoma. The patient underwent a full ophthalmologic examination, spectral-domain optical coherence tomography (SD-OCT), and imaging with prototype AO-SLO systems (Canon Inc.) at 14 and 22 months after the injury. Images focused on the photoreceptor layer were recorded in the foveal area, and a montage of AO-SLO images was created. On AO-SLO, focal dark areas could be observed in the left eye at 14 months after the injury. The analysis showed that the cone mosaic (cone density, 16503/mm2; ratio of hexagonal Voronoi domain, 36.3 %; average nearest-neighbor distance (NND)/expected NND, 0.606) was disordered compared with the normal area of the same eye (cone density, 24821/mm2; ratio of hexagonal Voronoi domain, 44.1 %; average NND/expected NND, 0.739). The cone defect area corresponded to the area of the scotoma. A second AO-SLO was performed on the patient at 22 months after the injury and although there were still areas with reduced cone reflectivity, partial improvement of cone mosaic was detected by AO-SLO at this time point. Partial recovery of damaged cone photoreceptors following closed globe blunt ocular trauma can be documented using AO-SLO longitudinal tracking.