中心性晕轮状视网膜脉络膜萎缩的荧光素眼底血管造影

Analysis of Fundus Fluoresce in Angiographies of Central Retinochoroidal Atrophy

目的 :探讨中心性晕轮状视网膜脉络膜萎缩 (centralareolarretinochoroidalatrophy,CARCA)的荧光素眼底血管造影 (fundusfluoresceinangiography,FFA)的特征。方法 :回顾分析 32例CACA患者 5 9只患眼的FFA检查资料。结果 :FFA可见视网膜色素上皮及脉络膜毛细血管萎缩灶 ,早期呈弱荧光 ,晚期呈透见荧光 ;病灶内有色素沉着者可见斑点状遮蔽荧光 ;萎缩灶边缘染色呈强荧光 ,荧光范围不扩大。病灶内可透见粗大的脉络膜血管。后期萎缩区巩膜染色呈强荧光。其中 2 5只眼有视盘周围环形脉络膜萎缩区 ,周边视网膜及视网膜血管正常。双眼发病且FFA表现对称者 2 7例 ,单眼发病者 5例。 2 6例 47只眼病灶范围在 1～ 2 5个PD之间 ,6例 12只眼病灶范围大于 3个PD或小于 1个PD。 2 8例 5 1只眼病灶呈圆形或椭圆形 ,边缘规则清楚 ;4例 8只眼病灶边缘不规则 ,边界欠清晰。 2例 3只眼黄斑未受累。结论 :CACA的FFA特征表现为萎缩区病灶边缘染色清楚的强荧光环 ,病灶内可呈现斑点状透见荧光、可透见粗大的脉络膜血管。后期萎缩区巩膜染色呈强荧光。

Objective:To analyze the characteristic of fundus flourescein angiography(FFA)of central areolar retinochoroidal atrophy(CARCA).Methods:FFA reports of 32 cases of CARCA were reviewed and analyzed.Results:FFA displayed atrophic area of retinal RPE and choroid capillary,hypofluorescence at early stage and transmitted fluorescence at late stage,mottled blocked fluorescence with pigment deposit in atrophic area,hyperfluorescence in the edge of atrophic area.The range of fluorescence did not enlarge,large choroid blood vessel can be seen.Hyperfluorescence in atrophic area with sclera staining at late stage.25 eyes with circular choroid atrophic area around papilla,periphery retina and retinal vascularity remained normal.27 cases with both eyes involved and showed symmetric in FFA.5 cases with single eye involved the atrophic scope of 26 cases 47 eyes ranged from 1 to 2.5 PD and 6 cases 12 eyes large than 3 PD or small than 1 PD.The shape of the atrophic area in 28 cases 51 eyes showed circular and ellipse with clear margin.The margin of atrophic area in 4 cases 8 eyes displayed irregular and blurred.The macular of 2 cases 3 eyes were normal.Conclusion:FFA characteristic of CARCA show hyperfluorescence circle on the margin of atrophic area,mottled transmitted fluorescence in the area and large choroid vessel can be seen,sclera staining showed hyperfluorescence at late stage.