眼钝挫伤的吲哚青绿血管造影

Indocyanine green angiography in ocular contusion

目的 观察眼挫伤后脉络膜、视网膜循环改变在影像学检查中的特征和临床意义。 方法 对 30例眼挫伤患者的 30只伤眼进行荧光素眼底血管造影 (fundus fluorescein angiography,FFA)和吲哚青绿血管造影 (indocyanine green angiography,ICGA)同步检查。 结果 19只眼 FFA表现为视盘象限性或全部弱荧光 (视盘缺血性改变 ) ,占 6 3.3% ,视盘象限性弱荧光区和脉络膜延迟灌注区相连。 2 6只眼出现局部脉络膜灌注不良 ,占 86 .7%。其中 16只眼为局限性充盈迟缓 ,脉络膜荧光完全充盈时间 :最短 1min 5 0 s,最长 5 min 43s;10只眼为局限性充盈缺损。视网膜脉络膜充盈时间倒置 6只眼 ,占 2 0 .0 % ;脉络膜及视网膜中央血管系统充盈均延迟者 5只眼 ,占 16 .6 %。在脉络膜局部灌注不良的部位均出现了视网膜色素上皮(retinal pigmentepithelium,RPE)的损害。 结论 ICGA可清楚地显示眼挫伤后脉络膜循环的改变 ,结合FFA同步检查 ,可对眼底损害作出更加全面的评价。

Purpose To observe the changes of choroidal circulation and the retinal lesions caused by ocular contusion with indocyanine green angiography (ICGA). Methods ICGA examination was performed on 30 cases (30 eyes) of various traumatic condition in conjunction with fundus fluorescein angiography (FFA). Results FFA of 19 cases (63.3%) showed the hypofluorence in quadrant or whole disc in accordance with the area of delayed filling of choroid. Twenty six cases (86.2%) showed defected choroidel perfusion in ICGA,among them 16 cases showed localized delayed perfusion, in which the shortest perfusion time was 1 min 50 s and the longest time was 5 min.43 s,and 10 patients showed localized perfusion defect,and reversed filling time of retinochoroid vessels in 6 patients. Five cases (16.6%) had delayed filling time in both choroidal and central retinal vessels. Damage of retinal pigment epithelium was found in the areas of choroidal abnormal perfusion. Conclusion ICGA combined with simultaneously FFA, is valuable in evaluating blunt injury of the ocular fundus and beneficial to its diagnosis and treatment.