息肉样脉络膜血管病变静止性息肉样灶的吲哚青绿血管造影特征分析  

Characteristics of indocyanine green angiography in inactive polypoidal lesions of polypoidal choroidal vasculopathy

作　　者：曾仁攀[1] 文峰[1] 张雄泽[1] 李猛[1] 左成果[1] 黄时洲[1] 罗光伟[1] 

机构地区：[1]中山大学中山眼科中心眼科学国家重点实验室,广州510060

出　　处：《中华眼底病杂志》2012年第5期449-453,共5页Chinese Journal of Ocular Fundus Diseases

基　　金：国家自然科学基金（81070745）

摘　　要：目的观察息肉样脉络膜血管病变（PCV）静止性息肉样灶的吲哚青绿血管造影（ICGA）特征。方法回顾分析36例有静止性息肉样灶的PCV患者37只眼的临床资料。其中，11只眼随访了9～29个月，平均随访时间（12．3±5．5）个月。所有患眼均进行视力、眼压、裂隙灯显微镜、散瞳眼底检查，以及眼底彩色照相、荧光素眼底血管造影、ICGA检查。以ICGA检查早期发现囊袋样强荧光和晚期荧光渗漏或者着染者确定为活动性息肉样灶；ICGA检查发现囊袋样稍强荧光，晚期逐渐消退或者呈“冲刷”样表现者确定为静止性息肉样灶。以吲哚青绿开始注射至静止性息肉样灶开始显影的时间定为静止性息肉样灶的显影时间。根据临床和ICGA表现，将静止性息肉样灶分为无症状组、萎缩瘢痕组、结合组。对比观察各组的临床和影像特征以及随访观察眼底及病灶变化情况。结果37只眼中，静止性息肉样灶的显影时间为8．2～27．0min，平均显影时间（15．5±4．8）min。无症状组5只眼，占13．5％。眼底检查无出血、渗出、视网膜色素上皮脱离（PED）和（或）神经上皮脱离。ICGA检查有静止性息肉样灶显影。萎缩瘢痕组8只眼，占21．60。眼底检查患眼黄斑区均有萎缩灶和（或）瘢痕灶，无出血、渗出、视网膜PED和（或）神经上皮脱离。ICGA检查显示其静止性息肉样灶位于萎缩灶或瘢痕灶边缘。结合组24只眼，占64．9％。眼底检查均无萎缩、瘢痕灶，其中10只眼有视网膜下出血，15只眼有视网膜渗出，10只眼有视网膜PED，4只眼有视网膜神经上皮脱离。ICGA检查显示静止性息肉样灶和活动性息肉样灶共存。随访的11只眼中，3只眼静止性息肉样灶完全消退，占27．3％；2只眼静止性息肉样灶部分消退，占18．2％；6只眼静止性息肉样灶无明显改变，占54．5％。结论PCV的静止性息肉样灶�Objective To observe the characteristics of indocyanine green angiography （ICGA） in inactive polypoidal lesions of polypoidal choroidal vasculopathy （PCV）. Methods The clinical data of 36 PCV patients （37 eyes） with inactive polypoidal lesions were retrospectively analyzed. The follow-up of 11 eyes were ranged from nine to 29 months, with a mean of （12.3 ± 5.5） months. All the patients were examined for visual acuity, intraocular pressure, slit lamp microscope, fundus photography, fundus fluorescein angiography （FFA） and ICGA. According to the ICGA characteristics, PCV lesions were divided into active polypoidal lesions （pocket like hyperfluorescenee at early stage and fluorescence leakage or stained with fluorescein at late stage） and inactive polypoidal lesions （pocket like hyperfluorescence and it was gradually faded）. According to clinical and ICGA characteristics, inactive polypoidal lesions were divided into asymptomatic group, atrophic and/or cicatricial group and combined （with active polypoidal lesions） group. The visual acuity, fundus, lesions change and image characteristics of three groups were evaluated and analyzed. Results Among the 37 eyes, the time from indocyanine green （ICG） injection to inactive polypoidai lesions begin showing was ranged from 8.2 to 27.0 minutes, with a mean of （15.5 ±4.8） minutes. There were five eyes （13.5%）, eight eyes （21.6%） and 24 eyes （64.9%） in asymptomatic group, atrophic and/or cicatricial group and combined group, respectively. The results of fundus examination showed that there was no hemorrhage, exudates, retinal pigment epithelium detachment （PED） and/or neural retina detachment in asymptomatic group; atrophy lesions and/or scar lesions were observed in atrophic and/or cicatricial group and there was also no hemorrhage, exudate, PED and/or neural retina detachment; there was no atrophy lesion and/or scar lesion, but there were 10 eyes with subretinal hemorrhage, 15 eyes with retinal exudate, 10 eyes with

关 键 词：脉络膜疾病/诊断 哚哚花青绿/诊断应用 疾病特征 

分 类 号：R773.4[医药卫生—眼科]