Analiza autofluorescencji siatkówki w wysiękowej postaci zwyrodnienia plamki związanego z wiekiem i porównanie z badaniem spektralnej optycznej koherentnej tomografii (SOCT)
Fundus Autofluorescence Analysis in Age-related Macular Degeneration and Choroidal Neovascularization and its’ Correlation with Spectral-Domain Optical Coherence Tomography Images
Bartosz Izdebski1, Zofia Michalewska1,2, Janusz Michalewski1,2, Zbigniew Pikulski2, Krzysztof Dzięgielewski2, Jerzy Nawrocki1,2, Dominik Odrobina1,2
1 Oddział Okulistyki III Szpitala Miejskiego im. K. Jonschera w Łodzi
2 Klinika Okulistyczna „Jasne Błonia” w Łodzi
Kierownik: prof. dr hab. n. med. Jerzy Nawrocki
Summary: Purpose: To analyze retinal changes with Spectral-Domain Optical Coherence Tomography (SOCT), fundus autofluorescence (FAF)
and fluorescein angiography in patients with age-related macular degeneration and choroidal neovascularization (CNV).
Material and Methods: 30 eyes of 30 patients with CNV were included in this study. Each of them had FAF, SOCT and AF examination using spectral-domain OCT (Spectralis Heidelberg Retinal Angiograph).
Results: CNV with pigment epithelium detachment (PED) was observed in 9 eyes, all cases presented with autofluorescence signal indistinguishable from background in the centre of PED in SOCT. Peripheral parts of the lesion had high autofluorescence. CNV without evidence of subretinal fibrosis was diagnosed in 17 eyes. CNV with subretinal fibrosis was observed in 4 eyes. In these cases we noticed hyperechogenic tissue in SOCT with leakage in AF and low autofluorescence. Margins of those lesions in most cases were hyperechogenic in SOCT and had high autofluorescence. Lower autofluorescence was observed among eyes with subretinal fibrosis where fibrosis was found.
Conclusions: The low autofluorescence signal observed at the site of the CNV was probably related to blockage of autofluorescence caused by the CNV growing in the subretinal space. A ring of high autofluorescence observed at the margin of the CNV in some cases may by related to proliferation of RPE cells or RPE dislocation by growing CNV. We can't precisely distinguish changes in CNV using SOCT. Combining FAF with SOCT may enable us to diagnose changes in CNV more accurately, that can be important when qualifying patients to treatment and anticipating treatment results.
Słowa kluczowe: autofluorescencja, spektralna optyczna koherentna tomografia siatkówki (SOCT), zwyrodnienia plamki związanego z wiekiem (AMD), wysiękowa postać.
Keywords: fundus autofluorescence, spectral-domain optical coherence tomography (SOCT), Age-related macular degeneration (AMD), choroidal neovascularization.