眼底血管荧光造影在特发性视网膜血管炎诊断和治疗中的应用

Application of fundus fluorescein angiography in diagnosis and treatment of idiopathic retinal vasculitis

目的 评价眼底血管荧光造影在特发性视网膜血管炎诊断和治疗中的指导意义.方法 回顾性系列病例研究.收集2010年1月至2012年6月期间河南省舞阳市舞阳钢铁有限责任公司职工医院诊治的特发性视网膜血管炎患者资料,共计12例16眼.对其治疗前后的眼底彩色照像、眼底血管荧光造影检查结果及其指导下实施的治疗方法进行归纳总结.结果 治疗前眼底彩色照相检查发现16眼中视盘明显水肿1眼,周边视网膜血管粗细不均、血管白鞘13眼,玻璃体积血3眼,玻璃体视网膜明显增殖性病变1眼,黄斑前膜1 眼.治疗前眼底血管荧光造影检查发现视盘渗漏9眼,视盘新生血管1眼,全部患眼周边视网膜血管管径不均、晚期可见静脉荧光着染及小分支血管渗漏、周边部无灌注区11眼,视网膜新生血管3眼,黄斑水肿5眼,黄斑前膜1眼.治疗1～3个月后复查的眼底血管荧光造影发现视盘渗漏2眼,周边视网膜血管仍有渗漏者5眼、无灌注区2眼,视网膜新生血管未退行1眼,需要继续用药及补充激光治疗.结论 眼底血管荧光造检查能够清晰显示特发性视网膜血管炎治疗前后炎性病变的程度、范围,监测病变的活动性,对指导特发性视网膜血管炎的治疗及治疗后随诊中的病情监测有重要价值.

Objective To evaluate the application value of fundus fluorescein angiography( FFA)in the diagnosis and treatment of idiopathic retinal vasculitis( IRV). Methods It was retrospective case series study. A total of 16 eyes in 12 patients of idiopathic retinal vasculitis from Jan. 2010 to Jun. 2012 in Wokers' hospital of wuyang iron and steel co.,ltd. were included in this study. All of them were undertaken color retinal images and FFA before and after 1 to 3months after treatment. The characteristics of IRV in FFA and color retinal images before and after treatment as well as the therapeutic methods which were adopted under the guide of these two examinations were retrospectively analyzed. Results In fundus checkup of all the 16 eyes before treatment, there was one eye with papilledema, thirteen eyes with eyesvascular inflammation,and three eyes with eyesvitreous haemorrhage,one eyeproliferative vitreous-retinopathy,and one eyepremacular membrane. FFA before treatment showed leakage of optic disc in nine eyes,neovascularization on disc in one eye,vein inflammation in sixteen eyes,nonperfusion area in eleven eyes,neovascularization elsewhere in three eyes,macular edema in five eyes,and premacular membrane in one eye. In the followup 1 to 3 months after treatment,FFA showed that there was leakage of optic disc in two eyes,vein inflammation in five eyes,nonperfusion area in two eyes,and neovascularization elsewhere in one eye which need to be treated. Conclusions FFA can clearly indicate the extent,position,and activity of IRV in detail,it can play an important role in guiding the IRA treatment as well as the follow-up.