Prognostication in Stargardt Disease Using Fundus Autofluorescence: Improving Patient Care

Ophthalmology Volume 130, Number 11, November 2023

中文摘要

本文描述了一項針對Stargardt病的後瞳自體螢光作用 (fundus autofluorescence, FAF)的預測研究。研究通過回顧性病例系列對Moorfields眼科醫院掛號的STGD患者進行分析，結果顯示居於不同年齡段的患者在眼底自體螢光成像（FAF）和電生理檢測(ERG)結果上存在明顯的差異。研究還提出了一種將FAF成像用於預測疾病發展情況的方法，並強調了兒童病例的特殊性。總的來說，該研究為Stargardt病的診斷和治療提供了重要的臨床資料，並對患者的後續管理提出了明確的建議。

English Abstract

This study aimed to assess the use of fundus autofluorescence (FAF) imaging as a prognostic tool for Stargardt disease (STGD) in comparison to electroretinography. The retrospective case series involved 234 patients meeting specific inclusion criteria. The results indicated that FAF imaging is effective in determining the extent of retinal involvement and can be used to inform prognostication. The study found a discrepancy between FAF and electroretinography in children with early-onset disease, suggesting that functional impairment detectable by electroretinography may precede structural loss detectable by FAF in this age group. Additionally, patients with milder FAF severity than electroretinography were significantly younger at the time of assessment and showed earlier age at onset. The study concluded that careful counseling and, ideally, electroretinography should be considered for the most accurate prognosis, especially in young patients with certain genetic variants and poor initial visual acuity. These findings have implications for patient care and decision-making in the management of STGD.