荧光素眼底血管造影和吲哚青绿血管造影在老年性黄斑变性视网膜下出血检查中的对比研究

Comparison of fundus fluorescein angiography and indocyanine green angiography for imaging of subretinal hemorrhage in age-related macular degeneration

目的 比较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)对老年性黄斑变性 ( age- related macular degeneration,AMD)视网膜下出血中脉络膜新生血管膜 ( choroidal neovascularization,CNV)的定位、分型 ,以及对出血面积测量的效果。 方法 选取经眼底彩色照相、FFA和 ICGA检查确诊为 AMD视网膜下出血的 177例患者 ( 177只眼 )的相关资料 ,分别在其 FFA和 ICGA图像上进行 CNV的定位和分型 ,并从中随机抽取 30例 AMD视网膜下出血患者的 FFA和 ICGA图像进行出血面积测量。 结果 FFA图像显示 ,177例患者中 ,16 0例患者 ( 90 .4%)的 CNV能够较明确定位和分型 ,2 4例患者 ( 13.6 %)的 CNV符合激光光凝条件 ;ICGA图像显示 ,175例患者 ( 98.9%)的 CNV能够较明确定位和分型 ,5 1例患者 ( 2 8.8%)的 CNV符合激光光凝条件。2种造影检查对 CNV定位和分型的差异均无显著性的意义 ( Z=- 0 .383,P=0 .70 1;χ2 =2 .993,P=0 .810 )。视网膜下出血的面积测量中 ,由 FFA测得的数值 ( x=2 6 .6 10 mm2 ,M=13.5 48mm2 )较 ICGA( x=2 4.714mm2 ,M=12 .875 mm2 )大 ,差异有显著性的意义 ( Z=- 3.0 0 0 ,P=0 .0 0 3)。 结论

Objective To compare the effects of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) on classifications and locations of choroidal neovascularization (CNV) located under subretinal hemorrhage in age-related macular degeneration, and on the area-measuring of subretinal hemorrhage. Methods The medical record of 177 patients with subretinal hemorrhage associated with AMD confirmed by photochrome of ocular fundus, FFA and ICGA examinations were retrospectively reviewed. The locations and classifications of CNV on the images of FFA and ICGA in the 177 patients and the area of subretinal hemorrhage of 30 patients randomly selected from the 177 patients were analyzed and measured. Results On the images of FFA, the locations and classifications of CNV could be defined in 160 patients (90.4%), and CNV was considered eligible for laser therapy in 24 patients (13.6%). On the images of ICGA, the locations and classifications of CNV could be defined in 175 patients (98.9%),and CNV was considered eligible for laser therapy in 51 patients (28.8%). There was no statistical difference of the locations (Z=-0.383,P=0.701) and classifications (χ2=2.993,P=0.810) of CNV on the images of FFA and ICGA. The areas of blocked fluorescence measured on the images of FFA (=26.610 mm2 and M= 13.548 mm2) were larger than those of ICGA (=24.714 mm2, M=12.875 mm2) with statistical differences (Z=-3.000,P=0.003) between FFA and ICGA. Conclusions ICGA is beneficial for imaging CNV located under subretinal hemorrhage, and may increase the number of the patients who are considered eligible for laser treatment. The effect of measurement of the area of subretinal hemorrhage in AMD evaluated by FFA is better.