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Bardet-Biedl综合征眼底病变影像学特征

李倩  彭晓燕  张永鹏  朱晓青  周海英
  

  1. 1000730首都医科大学附属北京同仁医院 北京同仁眼科中心 眼科学与视觉科学北京市重点实验室
  • 收稿日期:2016-10-02 出版日期:2017-05-25 发布日期:2017-06-02
  • 通讯作者: 彭晓燕,Email:drpengxy@163.com E-mail:drpengxy@163.com
  • 基金资助:

    北京市医管局青年人才培养“青苗”计划(QML 20150205)

Retinal imaging charasteristics of patients with Bardet-Biedl syndrome

LI Qian, PENG Xiao-yan, ZHANG Yong-peng, ZHU Xiao-qing, ZHOU Hai-ying   

  1. Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
  • Received:2016-10-02 Online:2017-05-25 Published:2017-06-02
  • Contact: PENG Xiao-yan, Email: drpengxy@163.com E-mail:drpengxy@163.com

摘要:

目的 了解Bardet-Biedl综合征(Bardet-Biedl syndrome,BBS)患者眼底病变的影像学特点。设计 回顾性病例系列。研究对象 北京同仁医院诊断的8例BBS患者。方法 回顾患者病历资料,分析患者全身情况,采用Sanger测序BBS1-BBS12基因进行基因诊断,并采用眼底彩像、眼底自发荧光(FAF)、频域相干光断层成像(SD-OCT)和增强深度成像(EDI-OCT)对患者眼底病变进行评估。主要指标 病变的影像学特征。结果  突变筛查确定了6例患者的致病突变分别位于BBS1、BBS2、BBS4和BBS7基因。所有患者均显示视盘蜡黄色萎缩、视网膜血管缩窄、中周部眼底视网膜色素上皮及脉络膜毛细血管层萎缩,且均有不同程度黄斑形态异常。SD-OCT显示不同BBS患者之间黄斑区视网膜形态改变存在较大差异,视网膜退行变类型可分为弥漫性退变、向心性退变和离心性退变三类。EDI-OCT检查显示6例患者(12眼)出现脉络膜毛细血管层薄变甚至消失。结论 多种视网膜影像学检查显示BBS患者黄斑区视网膜退行性改变可呈向心性、离心性以及弥漫性退变多种类型。

关键词: Bardet-Biedl综合征, 频域相干光断层成像, 增强深度成像

Abstract:

Objective To characterize the retinal imaging of Bardet-Biedl syndrome (BBS). Design Retrospective case series. Participants Eight probands clinically diagnosed as BBS in Beijing Tongren Hospital were included. Methods Data of systemic evaluation were recorded. Sanger sequencing for BBS1-BBS12 genes for genetic diagnosis. Retinal imaging analysis on the probands were performed with fundus photography, spectral-domain optical coherence tomography (SD-OCT), enhanced depth imaging (EDI) OCT and Fundus autofluorescence (FAF) . Main Outcome Measures Retinal imaging charasteristics. Results Mutations in 6 patients were demonstrated in the BBS1, BBS2, BBS4 and BBS7 genes. All of the probands displayed waxy pale of the optic disc, attenuation of the retinal vessels and atrophy of the mid-peripheral retinal pigment epithelium as well as the choriocapillaris. Furthermore macular involvement was exhibited. According to shown as SD-OCT, the abnormalities in macula were observed to differ among patients, implying 3 major degenerative types: the extensive, the concentric and the centrifugal. In EDI-OCT, the subfoveal choriocapillaris were delineated to be thinning and loss in 12 eyes of 6 patients. Conclusion The major degenerative patterns of BBS were shown to be concentric, centrifugal or extensive on multiple reitnal imaging modalities.

Key words: Bardet-Biedl syndrome, spectral-domain optical coherence tomography, enhanced depth imaging