摘要
目的探讨Vogt-Koyanagi-Harada(VKH)综合征患者的眼科影像学特征。方法回顾分析1997年10月至2011年5月在青岛眼科医院确诊为VKH综合征的50例(100眼)患者的荧光素眼底血管造影(FFA)、光学相干断层扫描(OCT)、眼部B型超声等眼科影像学检查结果,观察VKH综合征患者眼部的医学影像学特征。结果 FFA检查提示94眼造影早期视盘呈边界不清强荧光,晚期增强,早期后极部多处点状强荧光,晚期多灶性荧光渗漏,呈墨渍样扩大并彼此融合,其中85眼后期形成多灶性、大小不一的泡状荧光积存,7眼伴斑驳状荧光,9眼见条状低荧光。OCT检查发现85眼表现为黄斑区神经上皮层多灶性渗出性脱离,9眼黄斑中心凹处神经上皮层局限性渗出性浅脱离,8眼黄斑区神经上皮层多灶性脱离、渗出不明显但伴有视网膜色素上皮细胞层及脉络膜毛细血管层波浪样隆起。眼部B超检查发现100眼均表现为后极部脉络膜弥漫性增厚,65眼见玻璃体内大量细小弱回声点,96眼见视盘隆起,85眼见后极部多发渗出性视网膜脱离并累及黄斑区,10眼伴周边部睫状体脉络膜扁平脱离,3眼仅见黄斑区视网膜局限性浅脱离。结论 VKH综合征患者的FFA、OCT、眼部B超等影像学检查均有特征性表现,根据患者眼部及全身情况,合理选用上述检查,可提高VKH综合征的确诊率。
Objective To investigate the ocular image characteristics of Vogt-Koyanagi-Harada （VKH） syndrome. Methods The history and clinical findings of 50 VKH patients （ 100 eyes） examined in Qingdao Eye Hospital from October 1997 to May 2011 were reviewed. Auxiliary examinations, including fundus fluorescein angiography （FFA） , optical coherence tomography （OCT） and B-scan ultrasonography were performed in all cases and the char- acteristics of the images were studied. Results In the early stage, FFA showed that hyperfluorescein had blurry boundary of peripapillary and fluorescein enhanced subsequently, Multifocal pinpoint dye leakage was found in the posterior pole in the early stage and multiple patchy bullous dye leakage and dye accumulation were found in the late stage. Late-phase multiple patchy bullous dye accumulation was found in 85 eyes, depigmentation of choroidal mela- nocytes in 7 eyes, and strip low fluorescein in 9 eyes. In OCT images, multiple patchy bullous exudative retinal de- tachments were found in the macular area in 85 eyes. From B-scan ultrasonography images, we found diffuse reflec- tive thickening of the choroid posteriorly in all the 100 eyes, a great deal of fine and mild points in vitreous cavity in 65 eyes, multiple patchy bullous exudative retinal detachments in the posterior pole in 85 eyes, peripheral ciliary and choroidal detachments in 10 eyes, and localized macular detachment only in 3 eyes. Conclusions The images of FFA, OCT and B-scan ultrasonography of VKH syndrome had special characteristics. According to the history and clinical manifests, choosing suitable auxiliary examinations above-mentioned could improve the diagnosis level.
出处
《山东大学耳鼻喉眼学报》
CAS
2012年第5期80-82,87,共4页
Journal of Otolaryngology and Ophthalmology of Shandong University
