多灶性脉络膜炎的吲哚青绿眼底血管造影观察

Indocyanine green angiogram in multifocal choroiditis

目的探讨利用吲哚青绿眼底血管造影(indocyanine green,ICGA)检查作为多灶性脉络膜炎临床观察指标的意义。方法分别对29例(45眼)多灶性脉络膜炎患者荧光素眼底血管造影(fundus fluorescein angiography,FFA)和ICGA检查资料进行分析,根据其造影特点分为临床前期、活动期、瘢痕期。结果临床前期10例(17眼)患者FFA表现正常,而ICGA造影后期出现了大小不一的弱荧光斑;活动期13例(19眼)患者FFA表现造影早期弱荧光斑,造影后期强荧光斑,ICGA造影早期表现为弱荧光斑,其间可夹杂有强荧光斑,其弱荧光斑的数量多于FFA所见;瘢痕期6例(9眼)患者有2眼造影后期出现3～4个新弱荧光斑,其他7眼患者FFA表现强荧光但无渗漏,ICGA各期均表现为弱荧光斑,其病灶范围和个数与FFA相对应。结论 IC-GA能较好地提供多灶性脉络膜炎脉络膜循环损害的信息,并可指导治疗及判断视力预后。

Objective To investigate the significance of indocyanine green angiography（ICGA） as a clinical index to examine patients with multifocal choroiditis（MC）.Methods Fundus fluorescein angiography（FFA） and ICGA data of 29 cases（45 eyes） with MC were compared and analyzed.According to angiography characteristics,MC was classified into preclinical stage,active stage and scar stage.Results At preclinical stage,10 cases（17 eyes） were with normal FFA,but with hypofluorescence spots at various sizes at later stage of ICGA.At active stage,13 cases（19 eyes） were found with hypofluorescence spots at early stage of FFA,with hyperfluorescence spots at last stage of FFA,and with hypofluorescence spots including some hyperfluorescence spots at early stage of ICGA,the amount of which was more than FFA.At scar stage,2 eyes of 6 cases（9 eyes） were with 3 to 4 new hypofluorescence spots at later stage,and the other 7 eyes with hyperfluorescence but without leakage by FFA,while ICGA showed hypofluorescence at each stage opposite to hyperfluorescence by FFA.Conclusion ICGA can provide information of choroid circulation injury in MC,make a guidance for treatment and determine the prognosis of visual acuity.