多发性硬化患者的荧光素眼底血管造影 特征分析

目的 观察多发性硬化（MS）患者的荧光素眼底血管造影（FFA）表现特征以及在MS临床诊断中的应用价值。 方法 回顾分析神经内科经核磁共振成像（MRI）、脑脊液检查确诊的MS患者42例84只眼的视力、散瞳直接检眼镜眼底检查、FFA检查、视野检查、脑脊液检查、视觉诱发电位（VEP）和MRI检查的临床资料。 结果 42例患者的84只眼中，散瞳直接检眼镜检查、脑脊液检查、视野检查、VEP和MRI检查的阳性检出率分别为36.9％、21.4％、71.4%、83.3％和100%。44只眼有FFA异常，占52.4%。其中，病程早期的4只眼表现为视盘炎，占4.8%，视野有生理盲点扩大和中心暗点；病程早中期的7只眼表现为视神经视网膜炎，占8.33%，视野有中心或旁中心暗点；病程晚期的33只眼表现为视神经萎缩，占39.3%，视野为向心性缩窄，甚至呈管状视野。 结论 MS的FFA图像多表现为视盘炎、视神经视网膜炎和视神经萎缩的特征。FFA检查结果结合脑脊液检查、视野检查、VEP和MRI检查结果综合分析，有助于全面、准确地诊断MS，具有重要的临床价值。(中华眼底病杂志,2005,21:300-302)

Analysis of manifestation of fundus fluorescein angiography in multile sclerosis

Objective To observe the features of the manifestations of fundus fluorescein angiography (FFA) in multiple sclerosis (MS) and their value in clinical diagnosis. Methods The clinical data of 42 patients (84 eyes) with MS diagnosed by magnetic resonance imaging (MRI) and examination of cerebrospinal fluid (CSF) were retrospectively analyzed. The clinical data included visual acuity, ocular fundus examined by direct ophthalmoscope after mydriasis, FFA, visual field, CSF,visual evoked potential (VEP) and MRI examination. Results In 42 patients (84 eyes),the positive detectable rate of examination of direct ophthalmoscope, CSF, visual field, VEP, and MRI was 36.9%, 21.4%, (71.4%, and) 83.3% respectively. Abnormal results of FFA were found in 44 eyes (52.38%), including papillitis in 4 eyes (4.76%)at the early stage with extended physiological scotoma and central scotoma; neuroretinitis in 7 eyes (8.33%)at the medium stage with central or para- central scotoma; optic atrophy in 33 eyes(39.29%) at the late stage with centripetal constriction and even tubular visual field. Conclusion The main angiographic features of MS are papillitis, neuroretinitis and optic atrophy. The manifestations of FFA combined with the results of examination of CSF,visual field, VEP and MRI is helpful for comprehensive and exact diagnosis of MS.