萎缩型老年性黄斑变性的吲哚青绿和荧光素眼底血管造影观察

Indocyanine green angiography and fundus fluorescein angiography in atrophic age-related macular degeneration

目的 观察和评价萎缩型老年性黄斑变性 ( age- related macular degeneratioin,AMD)的荧光素眼底血管造影 ( fundus fluorescein angiography,FFA)与吲哚青绿血管造影 ( indocyanine green angiogra-phy,ICGA)图像特征和对比检查的应用价值。 方法 回顾分析 73例萎缩型 AMD患者 95只眼的彩色眼底照相、FFA和 ICGA检查资料 ,其中包括视网膜色素上皮 ( retinal pigment epithelium,RPE)色素脱失与萎缩 19例 2 6只眼、玻璃疣 15例 30只眼和 39例单侧渗出性 AMD患者的对侧眼 39只。 结果 2 6只RPE色素脱失与萎缩的眼中 ,2 4只色素脱失眼 FFA表现为晚期斑片状强荧光 ,ICGA表现为斑片状强弱相间荧光 ;地图状萎缩 2只眼 ,FFA表现为斑片状强荧光 ,ICGA表现为边界清晰的弱荧光内见脉络膜毛细血管缺损 ,仅有脉络膜大血管。 8只硬性玻璃疣眼 FFA表现为强荧光 ,ICGA表现为持续斑点状强荧光 ;16只软性玻璃疣眼 FFA表现为强荧光 ,ICGA表现为持续性斑片状强弱相间荧光 ;6只同时有软性和硬性玻璃疣眼 FFA表现为强荧光 ,ICGA表现为斑点状强弱相间荧光。当玻璃疣 ICGA表现为弱荧光时 ,FFA所见到的玻璃疣的数量及范围较 ICGA所见者更多更大 ;当玻璃疣 ICGA表现为强荧光时 ,FFA检查所见到的玻璃疣的数量及范围较 ICGA?

ObjectiveTo observe and estimate the image characters of indocyanine green angiography (ICGA) and fundus fluorescein angiography (FFA) in atrophic age-related macular degeneration(AMD) and macular drusen.MethodsFFA, ICGA and fundus photography were performed on 95 eyes of 73 atrophic AMD patients, including 19 patients (26 eyes) with depigmentation and atrophy of retinal pigment epithelium (RPE), 15 (30 eyes) with macular drusen, and 39 (39 fellow eye) with unilateral exudative AMD. ResultsIn 26 eyes with depigmentation and atrophy of RPE, the result of FFA of 24 eyes with depigmentaion showed patch hyperfluorescence, and of ICGA showed patch hyperfluorescence and hypofluorescence on the late photographs; in 2 eyes with maplike atrophy of RPE, the result of FFA showed patch hyperfluorescence, and of ICGA showed choriocapillaris defect with sharply demarcated boundaries and hypofluorescence of large choroidal vessels. In 30 eyes with macular drusen, the result of FFA of 8 eyes with hard drusen showed hyperfluorescence, and of ICGA showed patch and spot hyperfluorescence; the result of FFA of 16 eyes with soft drusen showed hyperfluorescence, and of ICGA showed persistent patch hypofluorescence intermixed with cluster hyperfluorescence; and the result of FFA of 6 eyes with both soft and hard drusen showed hyperfluorescence, and of ICGA showed patch hyperfluorescence intermixed with hypofluorescence. When it was hypofluorescence in ICGA in patients with macular drusen, larger quantity and range of fluorescence were found in FFA than in ICGA; when it was hyperfluorescence in ICGA, smaller quantity and range of fluorescence were found in FFA than in ICGA. In 39 fellow eyes of unilateral exudative AMD, 32 or 31 eyes, examined by ICGA or FFA, had abnormal fluorescence of drusen and depigmentation and atrophy of RPE damage.ConclusionsSimultaneous examination of ICGA and FFA can be useful for accurate evaluation of fundus image characters of types of angiography in atrophic AMD.