伏格特-小柳-原田综合征并发脉络膜皱褶的临床特征  

Clinical Characteristics of Choroidal Folds in Vogt-Koyanagi-Harada Syndrome

作　　者：孙荣[1] 陈长征[1] 周芸芸[1] 郑红梅[1] 余运娴[1] 邢怡桥[1] 

机构地区：[1]武汉大学人民医院眼科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2009年第3期396-399,F0003,共5页Medical Journal of Wuhan University

摘　　要：目的:研究伏格特-小柳-原田综合征(VKH)并发脉络膜皱褶患者眼底、眼底荧光血管造影(FFA)、吲哚青绿血管造影(ICGA)和光学相关断层成像(OCT)的影像学特点。方法:回顾性分析伏格特-小柳-原田综合征43例中并发脉络膜皱褶患者12例,所有患者均行FFA检查,2例患者行ICGA检查,4例患者行OCT检查。结果:43例VKH患者中,12例(27.9%)出现脉络膜皱褶。眼底表现为明显视网膜水肿,缺乏明显明暗相间的条纹,FFA中以数目不等细小条状弱荧光为主,有时也表现为粗大弱荧光,多围绕视乳头呈放射样排列。ICGA造影早期表现为条状低荧光或正常荧光,造影晚期为高荧光或低荧光,与眼底荧光素血管造影的低荧光条带相对应,但没有眼底荧光素血管造影明显。OCT显示脉络膜皱褶累及脉络膜和RPE层,呈波浪样或局部小突起。所有患者治疗后,脉络膜皱褶减少或消失。结论:VKH综合征并发脉络膜皱褶临床并不少见,FFA多表现为围绕视盘放射状弱荧光,治疗后可减少或消失。To study the image characteristics of fundus fluoreseein angiography （FFA）, in- doeyanine green angiography （ICGA）, and optical coherence tomography （OCT） of choroidal folds in Vogtoyanagi Harada （VKH） sydrome. Methods： A total of 43 patients of Vogt-Koyanagi-Harada sydrome underwent FFA examination, two patients underwent ICGA examination, and four patients underwent OCT examination. Results： In the 43 cases of VKH patients, 12 patients （27.9 %） showed choroidal folds. The fundi had the performance of edema obviously, and lacked of light and dark stripes. On FFA, there were mostly bands of fine hypofluorescent, sometimes with wide folds, and the bands were radiating from the optic disk. On ICGA, ehoroidal folds showed normal or hypofluorescence at early stage, and hyperfluorescence or hypofluorescence at late stage. The hyperfluorescence or hypofluorescence bands on ICGA were corresponding to the hypofluorescence of FFA, but not as obvious as those on FFA. OCT could directly display morphological characteristics of choroidal fold and showed that horoidal folds involved the retinal pigment epithelium and ehoroidal layer. After treatment, all the choroidal folds reduced or disappeared. Conclusion： Choroidal folds in Vogt-Koyanagi Harada sydrome are common clinical signs, which are characterized by folds radiating from the optic disk. The folds grad- ually disappeared with the relief of edema.

关 键 词：脉络膜皱褶 眼底荧光血管造影 吲哚青绿血管造影 光学相关断层成像 

分 类 号：R441.2[医药卫生—诊断学]