脉络膜转移癌的眼底荧光和吲哚青绿血管造影

目的 观察脉络膜转移癌的眼底荧光血管造影(FFA)和吲哚青绿血管造影(ICGA)特征．探讨两种造影方法对脉络膜转移癌诊断的意义。方法 通过共焦激光眼底扫描系统同步获得5例脉络膜转移癌患者双眼的FFA和ICGA图像。结果 5例中4例双眼发现占位性病变，FFA背景期肿物呈低荧光。静脉期肿物内出现针尖状高荧，中央疏而外周密，高荧缓慢扩大，中央低荧区逐渐缩小。晚期肿物内出现边界清晰的斑块状高荧，呈“铺路石”样表现；ICGA早期相(1分钟内)，肿物处表现为大面积低荧，周围脉络膜血管轻度扩张，边界欠光滑，其直径略小于眼底所见；其后，于低荧部位缓慢出现斑点状高荧光，边缘密集，中央散在；荧光随时问推移缓慢增强并扩大；晚期相表现为点、片状高荧，中央仍存低荧区，范围较早期相缩小，肿物边缘区域出现环形针尖样高荧，可能是视网膜色素上皮屏障受损征象。结论 FFA和ICGA对脉络膜转移癌的诊断和鉴别诊断有意义，IC-GA对FFA有辅助作用。但对不典型病例，仍须结合其他检查方法。

Fundus fluoresein angiography and indocyanine green angiography in choroidal metastasis

Objective To investigate the characteristics of fundus fluoresein angiogrphy (FFA) and indocyanine green angiography (ICGA) of choroidal metastasis for dicussing the significance of FFA and ICGA at the diagnosis of choroidal metastasis.Methods 5 cases of choroidal metastasis were examined by scanning laser ophthalmoscopy to perform fundus fluoresein angiography and indocyanine green angiography simultaneously.Results 4 cases of 5 had tumors in both eyes.It performed hypofluorescence at the background frame of FFA and spoted hypyfluorescence around tumor at the vein frame.Concentrated in the edge and scattered in the center.Then the spoted hypyfluorescence was enlarged and centeral hypofluorescence was lessened during the course of FFA.It showed patched hypyfluorescence with smooth boundary in the tumors at the later frame of FFA,just like slabstones.Early frames of ICGA (within 1 minute) performed diffuse homogenous hypofluorescence,with smooth margin.The diameter of it was smaller than that of the tumor.The showed pinpoint and mottled leakage against hypofluorescence background.Also concentrated in the edge and scattered in the center.Then the hypyfluorescence expended and intensed during the ICGA.Later frames performed pinpoint and flake leakage with hypofluorescence in the center.Mottled hyperfluorescence ring was finded in the edge of the tumor,like the trace of damage in retina pigment epithelium.Conclusions FFA and ICGA are helpful to the distinguish and diagnosis of choroidal metastasis.ICGA may give aid to FFA.But it may need other kind of examination to distinguish the untypical cases.