特殊类型葡萄膜炎眼底荧光血管造影分析

目的 探讨特殊类型葡萄膜炎患者的眼底图像特征及荧光素眼底血管造影(fundusfluorescein angiography,FFA)的特征.方法 回顾分析山西医科大学第一医院2005年4月至2008年2月在眼科门诊行FFA检查并确诊为葡萄膜炎的患者56例98只眼的眼底和FFA图像特征及相关临床资料.结果 56例98只眼葡萄膜炎患者中,双眼发病的有42例84只眼,单眼发病的有14只眼.其中以Behcet病(Behcet disease)最多有25例48只眼;Vogt-小柳-原田病(VKH)有13例25只眼;急性视网膜坏死综合征(ARNS)有10例16只眼;系统性红斑狼疮(SLE)伴葡萄膜炎有8例9只眼.多数患者眼底主要表现为:视盘充血,边界不清,黄斑呈囊样水肿,静脉迂曲扩张,动脉变细,后极部网膜弥漫性水肿.FFA主要表现为:视盘荧光着染且在中后期可见荧光渗漏,黄斑囊样荧光积存,网膜血管轻到中度荧光染色伴渗漏,视网膜深层平面片状荧光渗漏.VKH患者的眼底在赤道前网膜下可见Dalen-Fuch结节.结论 不同疾病可引起不同类型的葡萄膜炎.通过FFA检查可确诊特殊类型的葡萄膜炎,对其治疗起到重要的指导意义.

Characteristics analysis of fundus fluorescein angiography with special kinds of uveitis

Objective To observe the characteristics of fundus images and fundus fluoresceinangiography (FFA)in special kinds of uveitis.Methods The fudus image of FFA and clinical data of 56patients (98 eyes),who were diagnosed as special kinds of uveitis from Oct,2004 to Oct,2007,wereretrospectively analyzed.Results In the 56 cases (98 eyes)of special kinds of uveitis,bilateral lesionsoccurred in 42 patients(84 eyes), and the remaining 14 cases had the unilateral lesions.Among them, Behcet'sdisease was the most predominant(25 patients, 48 eyes ); followed by Vogt-Koyanagi-Harada syndrome(VKH)(13 patients,25 eyes); the third one was acute retinal necrosis syndrom (ARNS)( 10 patients, 16 eyes)anduveitis combined with systemic iups erthematosus (SLE)(8 patients, 9 eyes).The color fucus of most casesshowed that disc hyperemia with blurred edge,cystoid macular edema (CME),tortuous and ectasy veins,thinningz artery and extensive edema at the posterior pole.The FFA showed that optic disc pigmentation andfluorescence leakage in the advanced stage, cystoid macular fluorescence acumulation, vascular pigmentationcombined with fluorescence leakage, fluorescence leakage in the deep layer of the retina; Dalen-Fuch's noduleswas observed at the peripheral retina in VKH patients.Conclusion The etiopathogenisis of uveitis weredifferent.The fundns and FFA changes of different kinds of uveitis were of characteristics and also had somefeatures in common.Thus definite diagnosis of different kinds of uveitis according to FFA changes was veryconsiderable to guide the therapy.