MPPE的荧光素和吲哚青绿眼底血管造影的临床特征及意义.doc

MPPE的荧光素和吲哚青绿眼底血管造影的临床特征及意义
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作者:周才喜,李瑞峰,苑志峰,张胜娟
【摘要】目的:观察多发性后极部色素上皮病变(multifocal posterior pigment epitheliopathy,MPPE)的荧光素眼底血管造影(fundus fluorescein angiography,FFA)和吲哚青绿眼底血管造影(indocyanine green angiography,ICGA)特征及其临床意义。方法:回顾性分析200701/200904期间在我院就诊的35例51眼MPPE患者的临床资料。所有患者都接受了常规视力、裂隙灯、直/间接眼底镜检查,同时行眼底彩色照相和德国海德堡共焦激光视网膜仪(HRA2)的同步FFA和ICGA检查。结果:多灶性视网膜色素上皮(RPE)渗漏和脉络膜血管循环障碍(包括脉络膜血管充盈延迟以及脉络膜血管的扩张渗漏)是活动期MPPE患者在FFA和ICGA检查中的主要特征性改变。由于长期大量的RPE渗漏,部分患者会继发渗出性视网膜脱离,其中小部分在FFA检查中还有视网膜小血管普遍渗漏、视网膜无灌注区及新生血管形成、晚期视盘强荧光着色等慢性葡萄膜炎的改变。静止期MPPE患者在FFA和ICGA中的荧光改变则主要为RPE和脉络膜毛细血管的萎缩,而脉络膜血管充盈迟缓和血管扩张等循环异常变化基本消失。结论:MPPE有类似CSC的FFA和ICGA改变,但程度更重;其中部分患者还可伴有类似慢性葡萄膜炎的改变。MPPE的ICGA后期像中的暗黑色低红外荧光灶有助于我们判断患者病情的预后。
【关键词】脉络膜视网膜炎;色素上皮;吲哚青绿
;诊断应用;荧光素血管造影术
Abstract AIM: To observe the features and the clinical significance of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) in multifocal posterior pigment epitheliopathy (MPPE). METHODS: The clinical data of 35 cases (51 eyes) with MPPE during Jan. 2007 to Apr. 2009 were analyzed retrospectively. All the patients received the conventional examination, including the vision, slitlamp, the direct/indirect ophthalmoscope examination, and the fundus color photography, FFA and ICGA with heidelberg retinal confocal laser instrument (HRA2) were also carried : The multifocal retinal pigment ep