脉络膜骨瘤多种眼底影像特征对比观察

摘要

目的 对比观察脉络膜骨瘤患者的多种眼底影像特征.方法 回顾性病例研究.临床检查确诊的脉络膜骨瘤患者16例16只眼纳入研究.其中,男性6例6只眼,女性10例10只眼.平均年龄(30.5±2.4)岁.所有患者均行最佳矫正视力、裂隙灯显微镜、间接检眼镜、眼底彩色照相、眼底自身荧光(AF)、荧光素眼底血管造影(FFA)、频域光相干断层扫描(OCT)检查.根据间接检眼镜及眼底彩色照相检查结果,将瘤体表面光滑、颜色红润、明显隆起定义为较新鲜瘤体;瘤体颜色苍白、扁平、表面有明显色素斑块定义为较陈旧瘤体.对比观察瘤体的彩色眼底像、AF、FFA、频域OCT的影像特征.结果 16只眼中,较新鲜瘤体5只眼;较陈旧瘤体11只眼.彩色眼底像显示瘤体颜色呈橙红色或黄白色,边界清晰,表面有视网膜血管分布;较新鲜瘤体颜色较为红润.AF表现为与彩色眼底像病灶一致的弱AF;较新鲜瘤体AF稍强于较陈旧瘤体AF,视网膜脱离区域呈相对强的AF.FFA较新鲜瘤体晚期呈边界清晰的均匀强荧光;较陈旧瘤体晚期荧光着染稍弱于较新鲜瘤体.频域OCT瘤体区域可见脉络膜层内网状反射信号,结构与周围脉络膜血管结构不同.结论 彩色眼底像瘤体颜色呈橙红色或黄白色,边界清晰;AF表现为与彩色眼底像病灶一致的弱AF;FFA瘤体早期呈斑驳样强荧光,晚期荧光着染;频域OCT瘤体区域可见脉络膜层内网状反射信号.%Objective To comparatively observe features of choroidal osteoma by multimodal fundus imaging methods.Methods This is a retrospective case study.Sixteen patients (16 eyes) with choroidal osteoma were enrolled in this study.The patients included 6 males (6 eyes) and 10 females (10 eyes),with an average age of (30.5±2.4) years.All patients received examination of best-corrected visual acuity,slit lamp microscope,indirect ophthalmoscopy,fundus color photography,fundus autofluorescence (AF),fundus fluorescein angiography (FFA) and spectral domain optical coherence tomography (SD-OCT).The tumors were classified as fresh lesion (clear boundary and rosy tumor with smooth surface) and obsolete lesions (pale and flat tumor with obvious patches).The tumor features of color fundus photography,AF,FFA and SD-OCT were comparatively observed.Results There were 5 fresh lesions and 11 obsolete lesions.Color fundus photography showed the tumor color was orange-red or yellow-white with clear boundary and retinal blood vessels on the surface of the tumor.The color of fresh lesion was rosy.In general,choroidal osteoma shown weak AF,however AF of fresh tumor was slightly stronger than the obsolete tumor,and retinal detachment region showed relatively stronger AF.FFA of fresh tumor indicated uniform intense fluorescence with clear boundary at late stage,much stronger than obsolete tumor.SD-OCT showed mesh-like reflected signal in the choroidal layer,but different from the surrounding choroidal vascular structures.Conclusions The tumor color is orange-red or yellow-white in color funds photography,which shown weak AF.FFA showed mottled hyperfluorescence in the early stage and tissue staining at the late stage.SD-OCT showed mesh-like reflected signal in the choroidal layer.