背景:通过使用不同的诊断方式/测试来描述非副肿瘤自身免疫性视网膜病变(npAIR)患者的纵向变化。
方法:该指标研究是对三级眼科医院诊断为npAIR的8名患者的16只眼进行的回顾性纵向回顾。多种诊断方式,如广角眼底摄影(WAFP),WA眼底自发荧光(WAFAF),频域光学相干层析成像(SD-OCT),戈德曼视野(GVF)视野,显微视野(MP),电生理测试,和自适应光学扫描激光检眼镜(AOSLO)进行了回顾和分析。
结果:在基线访视时,所有患者均通过多模态诊断测试发现异常.对受试者进行随访,中位持续时间为11.5[3.0-18.7]个月。在WAFP和WAFAF的16只眼中的14只(87.5%)和SD-OCT的16只眼中的13只(81.2%)中检测到基线时的结构变化。接受AOSLO成像的十只眼睛中有八只(80%)描绘了结构变化。在GVF的16只眼中有14只(87.5%)检测到功能变化,对MP的16只眼睛中的15只(93.7%),16只眼中的11只(68.7%)在全视野视网膜电图(ff-ERG)上。14只眼进行多焦视网膜电图(mf-ERG)和视觉诱发电位(VEP)测试,其中12只(85.7%)和14只(100%)眼睛表现出功能异常,分别,在基线。与所有其他结构诊断工具相比,AOSLO具有更好的能力来证明在随访中发生的视网膜微结构的恶化。在随访时,在10只眼睛中的8只(80%)在GVF上检测到功能恶化,8只眼睛中的4只(50%)的mf-ERG,16只眼中的7只(43.7%)和MP。在随访中,大多数病例的ff-ERG和VEP稳定。
结论:在npAIR患者的诊断和监测中使用多模态成像/测试可以帮助识别随时间的异常变化。通过这些设备对解剖和功能方面的分析可以支持早期检测这些患者的变化。AOSLO显示出希望,因为它能够捕获高分辨率图像,证明视网膜微观结构的可量化变化。
BACKGROUND: To describe longitudinal changes in patients with non-paraneoplastic autoimmune retinopathy (npAIR) by utilizing different diagnostic modalities/tests.
METHODS: The index study is a retrospective longitudinal review of sixteen eyes of eight patients from a tertiary care eye hospital diagnosed with npAIR. Multiple diagnostic modalities such as wide-angle fundus photography (WAFP), WA fundus autofluorescence (WAFAF), spectral-domain optical coherence tomography (SD-OCT), Goldmann visual field (GVF) perimetry, microperimetry (MP), electrophysiologic testing, and adaptive optics scanning laser ophthalmoscopy (AOSLO) were reviewed and analyzed.
RESULTS: At the baseline visits, anomalies were detected by multimodal diagnostic tests on all patients. Subjects were followed up for a median duration of 11.5 [3.0-18.7] months. Structural changes at the baseline were detected in 14 of 16 (87.5%) eyes on WAFP and WAFAF and 13 of 16 (81.2%) eyes on SD-OCT. Eight of the ten (80%) eyes that underwent AOSLO imaging depicted structural changes. Functional changes were detected in 14 of 16 (87.5%) eyes on GVF, 15 of 16 (93.7%) eyes on MP, and 11 of 16 (68.7%) eyes on full-field electroretinogram (ff-ERG). Multifocal electroretinogram (mf-ERG) and visual evoked potential (VEP) tests were performed in 14 eyes, of which 12 (85.7%) and 14 (100%) of the eyes demonstrated functional abnormalities, respectively, at baseline. Compared to all the other structural diagnostic tools, AOSLO had a better ability to demonstrate deterioration in retinal microstructures occurring at follow-ups. Functional deterioration at follow-up was detected on GVF in 8 of 10 (80%) eyes, mf-ERG in 4 of 8 (50%) eyes, and MP in 7 of 16 (43.7%) eyes. The ff-ERG and VEP were stable in the majority of cases at follow-up.
CONCLUSIONS: The utilization of multimodal imaging/tests in the diagnosing and monitoring of npAIR patients can aid in identifying anomalous changes over time. Analysis of both the anatomical and functional aspects by these devices can be supportive of detecting the changes early in such patients. AOSLO shows promise as it enables the capture of high-resolution images demonstrating quantifiable changes to retinal microstructure.