一例脉络膜黑色素瘤的眼科影像学改变

Angiography Characters Changes of Melanoma of Choroid: A Case Report

目的:报道1例脉络膜黑色素瘤的眼科影像学改变。方法:回顾性分析1例经病理确诊脉络膜黑色素瘤患者的荧光素眼底血管造影(fundus fluorescein angiography,FA)、吲哚菁绿血管造影(indocyanine green angiography,ICGA)、B超、光相干断层扫描(optical coherence tomography,OCT)等特征。结果:FA检查显示造影早期左眼后极大片遮蔽荧光和散在点状高荧光,造影晚期可见病灶处呈融合加强的点片状高荧光,没有发现明显的异常粗大血管和典型的“双循环征”。ICGA 检查显示早期病灶区呈弱荧光和脉络膜毛细血管点状高荧光,晚期病灶区呈点片状强荧光, 没有发现明显的“发夹样”或“鸡冠样”等异常血管荧光征象。光相干断层扫描(OCT)检查见视网膜全层及脉络膜毛细血管层向玻璃体腔内隆起,B超检查显示左眼玻璃体后段见起自眼球后极部中强回声光团。结论:脉络膜黑色素瘤FA和ICGA可出现不同的表现形式,因此对于眼底造影特征不典型的患者,要结合其他检查共同分析,并密切随诊。

Purpose：To report the ophthalmologic graphic characters of a case of melanoma of Choroid. Methods：Retrospectively analysis the characters of fundus fluorescein angiography （FA）, indocyanine green angiography （ICGA）, B-ultrasonic scan and optical coherence tomography （OCT） of a melanoma of choroid patient whose diagnosis has been made by pathology. Results：FFA of the left eye indicated there were large sheets of obscure fluorescence and scattered hyperfluorescence spots in the early stage.In the late stage we found confluent hyperfluorescence spots strengthened in the focus area and no obvious abnormal vessels or typical ＂double circulation sign＂ appeared. ICGA＇s early stage showed hypofluorescence in the focus area and hyperfluorescence spots of choroid blood capillarys. In the late stages of ICGA, we found sheets of hyperfluorescence upon the focus area and no obvious ＂barrette-like＂or ＂comb-like＂abnormal vessel signs. OCT found all layers of the retina and the ehoroideapillary layer hunched to the vitreous cavity. B-ultrasonic scan indicated high-echo mass situated in the posterior pole. Conclusion：The melanoma of choroid＇s FA and ICCA can display different forms .so we should apply to other examinations besides these two angiography ecamindtions and have frequently followed up when we are confronted with atypical melanoma of choroid patients.