Behcet病和Vogt-Koyanagi-Harada综合征的吲哚青绿及荧光素眼底血管造影分析  

Fundus fluorescein and indocyanine green angiographic study of Behcet′s disease and Vogt-Koyanagi-Harada syndrome

作　　者：陈玲[1] 杨培增[1] 文峰[1] 周红颜[1] 黄祥坤[1] 

机构地区：[1]中山大学中山眼科中心

出　　处：《中华眼科杂志》2002年第4期210-212,T002,共4页Chinese Journal of Ophthalmology

基　　金：国家杰出青年基金资助项目 (3 992 5 0 3 4)

摘　　要：目的　探讨Behcet病和Vogt Koyanagi Harada(VKH)综合征的脉络膜视网膜病变特征。方法　对 17例 (2 7只眼 )具有活动性葡萄膜炎的Behcet病和 18例 (36只眼 )VKH综合征患者行吲哚青绿血管造影术 (indocyaninegreenangiography ,ICGA)和荧光素眼底血管造影术 (fundusfluoresceinangiography,FFA)检查 ,对其脉络膜视网膜进行观察。结果　Behcet病患者中 ,FFA检查显示均有视网膜微血管渗漏 ;ICGA检查发现 11只眼 (40 7% )有脉络膜血管扩张 ,通透性增强。VKH综合征患者中 ,FFA后期检查可见视网膜微血管呈多湖状染料积存、视盘染色或弥散性视网膜色素上皮 (retinalpigmentepithelium ,RPE)损害 ;ICGA检查 ,发现 36只眼 (10 0 0 % )脉络膜血管扩张、通透性增强 ,其中多灶性弱荧光斑 32只眼 (88 9% ) ,脉络膜灌注不良 2 8只眼 (77 8% )。结论　Behcet病是以视网膜血管炎为主的炎性病变 ,但脉络膜亦可受累 ;VKH综合征主要累及脉络膜和RPE ,ICGA主要表现为脉络膜血管扩张和多灶性弱荧光。Objective To study the choroidal and retinal changes in Behcet′s disease and Vogt Koyanagi Harada syndrome (VKHS) using indocyanine green angiography (ICGA) and fundus fluorescein angiography (FFA). Methods Seventeen cases (27 eyes) of Behcet′s disease and 18 cases (36 eyes) of VKHS were examined with FFA and ICGA. All of the patients showed an active intraocular inflammation when examined. Results FFA showed leakage from retinal vessels in patients with Behcet′s disease. ICGA revealed choroidal abnormalities including dilatation and hyperpermeability of choroidal vessels in 11 eyes (40 7%). In VKHS, FFA revealed the hyperfluorescence and serous pigment epithelium detachments. Dilatation and hyperpermeability of choroidal vessels revealed by ICGA were found in 36 eyes (100%), multihypofluorescent dark dots in 32 eyes (88 9%), and choroidal filling defects in 28 eyes (77 8%). Conclusions Although retinal vascular lesions are predominant in Behcet′s disease, choroidal abnormalities evidenced by dilatation of choroidal vessels are also present in some patients. Hyperfluorescence and hypofluorescence revealed are the main findings in the patients with VKHS. A combination of FFA and ICGA is recommended for the examination of Behcet′s disease and VKHS.

关 键 词：荧光素血管造影术 吲哚花青绿 诊断 BEHCET病 VOGT-KOYANAGI-HARADA综合征 小柳-原田综合征 

分 类 号：R773.9[医药卫生—眼科]