黄斑囊样水肿患者白发荧光与黄斑色素密度的关系

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一2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MonteCarlo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（x2=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。

The correlation study of macular autofluorescence and macular pigment in cystoids macular edema

Objective To discuss the relationship between macular fundus autofluorecence and the density of macular pigment in the eyes with cystoid macular edema （CME）, furthermore to provide valuable parameters for patients follow up. Design Retrospective case series. Participants 24 eyes （18 cases） with diabetic macular edema, central vein occlusion and branch vein occlusion were in- eluded in the study from August 2009 to July 2010. 24 age and sex-matched normal eyes were enrolled as the control eyes. Methods CME was studied by color fundus photography, fluorescent angiography （FFA） and optical coherence tomography （OCT）. Autoflorescence was recorded by Heidelberg retinal angiography 2 （HRA2）system Fluorescein angiography （FA） model. Macular pigment was evaluated using HRA2 IF （infrared） and FA model. The density of macular pigment was graded into three categories： those without foveal macular pigment, those with partial maeular pigment and those with mormal amount macular pigment. Eyes from the age-matched subjects were used as the control eyes. Monte Carlo exact test was used to test the correlation of the density of macular pigment and the fundus antofluorecence. Liner by liner associate test was used to interpret the liner trend of the two variables. Main Outcome Measures Morphology and distribution of macular autofluoreeenee, the density and distribution of macular pigment. Results All the eyes with CME had petaloid-shaped autofluorecence in the macular area （100%）. No autofluorecence was found in the control eyes. The density of the macular pigment varied from without macular pigment （22 eyes, 91.7%） to partial macular pigment （2 eyes, 8.3%） accordingly in the eyes with CME. However, all the normal eyes present normal amount macular pigment （100%）. Macular autofluorecence presents minus correlation with the maeular pigment in the study. Conclusions The present of maeular autofluorecenee minus correlates the density of macular pigment. Macular autofluorecenee can be used as a follow up parameter for patients with CME.