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目的 观察周边部视网膜病变相关区域的自发荧光(AF)表现.方法 42例周边部视网膜病变患者60只眼纳入本研究.所有患者均经全景眼底视网膜照相和荧光素眼底血管造影(FFA)检查确诊.应用共焦激光眼底血管造影仪HRAⅡ行黑色素相关近红外自发荧光(NIA)及脂褐质相关自发荧光(FAF)检查,分别采用波长为795、488 nm的激光激发成像.记录9张/s,由共焦激光眼底血管造影仪HRAⅡ自动合成高分辨影像视野为55°,像素为822×768的最终AF像.将AF像是否可见眼底血管及相关视网膜组织成像的影像判断为有、无价值AF像.病变区域是否出现符合正常血管和视网膜组织的荧光表现判断为正常、异常荧光.通过与图像背景灰度比较,将异常荧光分级为无荧光、弱荧光和强荧光,观察周边部视网膜病变相关区域的AF表现.对比分析NIA和FAF检查AF像均呈异常荧光表现者的异常荧光分级的一致性.结果 60只眼中,获取有价值AF像者53只眼,占88.33%;获取无价值AF像者7只眼,占11.67%.NIA检查显示,获取有价值AF像的53只眼中正常荧光28只眼,占52.83%;呈片状、圆点斑状、条带状异常荧光25只眼,占47.17%.FAF检查显示,获取有价值AF像的53只眼中正常荧光2只眼,占3.77%;呈片状或与色素分布较为一致或沿血管分布的异常荧光51只眼,占96.23%.两种检查均呈异常荧光表现的25只眼中,异常荧光分级一致者18只眼,占72.00%;异常荧光分级不一致者7只眼,占28.00%.结论 周边部视网膜病变相关区域存在不同程度的AF表现.

Objective To observe the autofluorescence (AF) manifestation in related lesions of periphery retinopathy. Methods Sixty eyes of 42 patients with periphery retinopathy underwent the examination of Optomap fundus photograph (200°) and fundus fluorescein angiography (FFA). The HRA Ⅱ melanin-related near-infrared fundus autofluorescence (NIA, excitation 795 nm) and lipofuscin-related fundus autofluorescence (FAF, excitation 488 nm) were measured for all the patients. The AF was recorded with nine images per second, and then a final AF image with 55° view and 822 × 768 pixel was generated by the HRA. AF images can be valuable or valueless if there was or was not visible blood vessels and related retinal tissues on the image. AF from lesion regions can be normal or abnormal fluorescence comparing to the normal vascular and retinal tissue AF. The abnormal fluorescence was divided into no AF, weak AF and strong AF relative to the background grayscale. The grading consistency of abnormal fluorescence based on FAF and NIA examination was comparatively analyzed. Results Valuable AF images were captured in 53/60 eyes (88. 33%)and valueless AF images were captured in 7/60 eyes (11.67%). Among 53 eyes with valuable AF image, NIA showed normal fluorescence in 28 eyes (52. 83%), abnormal fluorescence with sheet-like, dot-shaped or stripped in 25 eyes (47.17%); FAF showed normal fluorescence in two eyes (3.77 % ), abnormal fluorescence with sheet-like, scattered along vessels or pigments in 51 eyes (96.23 % ).Twenty-five eyes with abnormal fluorescence were observed both in two examinations, including same grades in 18 eye (72.00%) and different grades in seven eyes (28.00%). Conclusion The AF manifestation with different levels exists in related lesions of periphery retinopathy.