共焦激光扫描检眼镜在脉络膜黑色素瘤血管造影中的应用

Imaging analysis of microvascularization of melanoma of choroid with confocal scanning laser ophthalmoscope

目的将共焦激光扫描检眼镜(cSLO)应用于脉络膜黑色素瘤中,比较同步情况下的荧光素眼底血管造影(FFA)和吲哚青绿(ICGA)造影的肿瘤内部瘤体血管尤其是微血管的显示率,并对所显示的微血管图像特点加以描述。设计回顾性病例系列。研究对象14例(14眼)脉络膜黑色素瘤患者。方法对14例未经治疗的脉络膜黑色素瘤患者采用cSLO进行同步ICGA和FFA检查,每例患者均行不同深度的共焦系列扫描并对两种造影图像进行对比分析。主要指标脉络膜黑色素瘤内微血管显示率及其特征。结果14例患者中,12例(86％)ICGA肿瘤内部不同深度的共焦系列扫描中可以显示有微血管,而FFA检查仅4例(28％)可见瘤体微血管并且仅仅在早期。1例在FFA及ICGA均可见到粗大瘤体血管。只有1例在FFA及ICGA均未见到肿瘤内血管存在。两种检查方法在发现肿瘤内微血管方面差异有统计学意义(P=0．004)。结论应用共焦激光扫描检眼镜结合ICGA显示肿瘤内部微血管特征性改变较FFA更有优势。

Objective To compare the visibility of the microvascularization of melanomas of choroid between simultaneous fluorescein and indocyanine green angiography with confocal scanning laser ophthalmoscope, and describe the characteristic of microvasculization. Design Retrospective case series. Participants 14 patients （14 eyes） with melanoma of choroid. Methods Before treatment, 14 patients were examined with simultaneous fluorescein and indocyanine green angiography, and with confocal scanning laser ophthalmoscope, three-dimensional functional imaging of vascular structure were obtained. Main Outcome Measures Microvascularization and its characteristic of choroid melenoma. Results Microvascularization were disclosed in 86% patients with ICGA, while 28% patients were disclosed with FFA. There was only 1 patient with large-caliber tumor vessel in both FFA and ICGA. Only in 1 patient did we find no tumor vessel in either FFA or ICGA. There is significant difference between two techniques statistically （P=0.004）. Conclusion This study suggests confocal scanning laser ophthalmoscope combined with ICGA is superior to that combined with FFA in visibility of microvascularization of melanoma of choroid.