黄斑裂孔诊断的新方法:自体荧光检测

目的 评价自体荧光检测诊断黄斑裂孔的效果。方法 应用自体荧光检测黄斑裂孔。对黄斑裂孔、手术修补术的患者(组1)和作为对照的黄斑假洞或黄斑皱褶的患者(组2)，分别行眼底荧光血管造影、自体荧光检测、眼底彩照、无赤光和红外摄像检查，进行回顾性研究。其中自体荧光采用132型Heidelberg眼球探针，对所得到的9个图象进行平均处理。而所有患者手术前后都进行OCT Ⅲ检测。结果 10个术前被自体荧光检测发现的黄斑裂孔均由OCT确诊，而且所有病例的自体荧光信号均与黄斑裂孔相对应。自体荧光也可应用于术后，以评价裂孔的闭合程度。在OCT确诊裂孔闭合的所有患者以及对照组10例黄斑皱褶或假洞患者，均没有发现自体荧光。对照组均由OCT证实，没有黄斑裂孔的发生。结论 自体荧光检测是诊断黄斑裂孔的一个新方法，它同时能够检测术后黄斑裂孔的封闭效果，没有自体荧光则表明裂孔已封闭。

Autofluorescence as a novel approach to diagnosing macular holes

Aim To assess the capability of autofluorescence as a novel approach to diagnosing macular holes. Methods A retrospective chart review of patients w ho were diagnosed with macular hole and had surgical repair (Group 1) and of con trol patients who were diagnosed with pseudohole or macular pucker (Group 2). Us ing the Heidelberg Retina Angiograph (Heidelberg Engineering), autofluorescence, color fundus photos, red free and infrared photos were obtained for Group 1 and Group 2. Autofluorescence was graded with an averaged mean of nine images using Heidelberg Eye Explorer Version 1.3.2. In addition, OCT III was obtained for al l patients including pre and postoperative exams for the patients with surgical intervention. Results Ten patients were diagnosed with macular hole preoperativ ely with autofluorescence and confirmed by OCT. In all cases, there was a strong subfoveal autofluorescence signal corresponding to the macular hole. Autofluore scence was also used postoperatively to confirm surgical closure. In all cases w ith confirmed closure by OCT, there was no autofluorescence. Ten controls with d iagnosis of macular pucker or pseudohole demonstrated no autofluorescence. OCT c onfirmed the lack of macular hole in the control group. Conclusion Autofluores cence is a novel approach to demonstrating a macular hole. This technique can al so be used to confirm post operative outcome after macular hole repair. A lack o f autofluorescence corresponds with macular hole closure.