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目的探讨黄斑囊样水肿(CME)眼底自发荧光与黄斑色素密度的相关性,以提供对其预后有临床价值的技术参数。设计回顾性病例系列。研究对象2009年8月至2010年7月于北京同仁医院确诊CME的视网膜中央静脉阻塞、视网膜分支静脉阻塞及糖尿病视网膜病变的患者18例(24眼)。24只正常眼选自年龄及性别相匹配者。方法对所有患眼及正常对照眼行彩色眼底照相、荧光素眼底血管造影(FFA)及相干光断层扫描(OCT)确诊CME。采用海德堡公司HRA-2共焦激光扫描系统的IR(infrared)及FA(不注入荧光素钠)模式进行眼底自发荧光及黄斑色素密度的检测。黄斑色素密度按Zhang等分期法分为完整的黄斑色素、部分黄斑色素及黄斑色素缺失三级。采用Monte Carlo精确检验说明不同分级的黄斑色素密度与自发荧光的相关性,线性相关卡方检验分析两个变量之间的变化趋势。主要指标眼底自发荧光的分布及形态、黄斑色素的分布及密度。结果 24只CME眼自发荧光均为阳性(100%),并在黄斑区呈花瓣样表现,而正常对照眼的黄斑自发荧光均为阴性。CME眼中黄斑色素缺失22眼(91.7%),部分黄斑色素2眼(8.3%);正常对照眼黄斑色素密度均为完整的黄斑色素(100%)。黄斑色素密度与自发荧光的出现在本次研究中呈现负相关(χ2=45.123,P=0.0001)。结论 CME患者中黄斑色素密度大小与黄斑区自发荧光呈负相关,黄斑区自发荧光可做为其随诊的临床评价指标。
Objective To investigate the correlation between autofluorescence and macular densitometry in macular cystoid edema (CME), so as to provide technical parameters that have clinical value for its prognosis. Design retrospective case series. Participants 18 patients (24 eyes) with central retinal vein occlusion, retinal branch vein occlusion and diabetic retinopathy diagnosed in CME from August 2009 to July 2010 in Beijing Tongren Hospital. 24 normal eyes from age and gender matched. Methods Color fundus photography, fundus fluorescein angiography (FFA) and coherence tomography (OCT) were used to diagnose CME in all eyes and controls. Heidelberg HRA-2 confocal laser scanning system IR (infrared) and FA (not injected into the sodium fluorescein) model for autofluorescence and macular pigment density detection. Macular pigment density by Zhang et al. Into a complete macular pigment, macular pigment and macular degeneration of some of the three. The Monte Carlo test was used to demonstrate the correlation between macular pigment density and autofluorescence of different grading. The linear correlation chi-square test was used to analyze the change trend between the two variables. The main indicators of retinal autofluorescence distribution and morphology, macular pigment distribution and density. Results The autofluorescence of all 24 CME eyes was positive (100%) and showed a petal-like appearance in the macular area, while the macular autofluorescence of the normal control eyes was negative. There were 22 eyes (91.7%) with macular pigment loss in the CME eyes and 2 eyes (8.3%) with partial macular pigment. The macular pigment density in the normal control eyes was all macular pigment (100%). Macular pigment density and autofluorescence in this study showed a negative correlation (χ2 = 45.123, P = 0.0001). Conclusions Macular pigment density in CME patients is negatively correlated with autofluorescence in macular area. Autofluorescence in macular area may be used as a clinical evaluation index.