急性后极部多灶性鳞状色素上皮病变的吲哚青绿血管造影

Indocyanine green angiography of acute posterior multifocal placoid pigment epitheliopathy

目的探讨急性后极部多灶性鳞状色素上皮病变（ａｃｕｔｅｐｏｓｔｅｒｉｏｒｍｕｌｔｉｆｏｃａｌｐｌａｃｏｉｄｐｉｇｍｅｎｔｅｐｉｔｈｅｌｉｏｐａｔｈｙ，ＡＰＭＰＰＥ）的发病机制及病变的变化规律。方法用眼底荧光血管造影（ｆｕｎｄｕｓｆｌｕｏｒｅｓｃｅｉｎａｎｇｉｏｇｒａｐｈｙ，ＦＦＡ）和吲哚青绿血管造影检查（ｉｎｄｏｃｙａｎｉｎｅｇｒｅｅｎａｎｇｉｏｇｒａｐｈｙ，ＩＣＧＡ）观察本病的改变，共６例（８只眼），其中１例观察１６０天。结果①ＦＦＡ：３只眼急性病变病灶早期为弱荧光，以后着染荧光。５只眼陈旧病灶为色素上皮脱色素的窗样缺损及色素沉着的遮蔽荧光；②ＩＣＧＡ：３只眼急性期病变呈斑片状充盈缺损，４只眼陈旧病灶弱荧光斑未见恢复，１只眼无异常表现。结论本病变发病为脉络膜毛细血管阻塞。

Purpose To investigate the clinical features and pathogenesis of acute posterior multifocal placoid pigment epitheliopathy(APMPPE). Methods To observe the features in 8 eyes of 6 cases of APMPPE with fundus fluorescein angiography(FFA) and indocyanine green angiography(ICGA).One of the cases had been observed continuously for 160 days. Results 1.FFA: at the acute stage of APMPPE,the affected foci showed low fluorescence in the early phase and stained gradually in 3 eyes;the fluorescence of recessive foci were still lower in 4 eyes,and the stale one showed window defect fluorescence due to some RPE fading and fluorescence sheltering due to pigment deposit.2.ICGA:at acuted stage,the fluorescence of choroid lobules was often defected untill in late period of pathogenical changes. Conclusion The findings demonstrate the obstruction of choriocapillaries may be the primary pathogenesis of APMPPE.