不同激发光下陈旧性眼底出血自身荧光的观察

目的 观察不同波长光线激发的陈旧性眼底出血的自身荧光现象。 方法 23例陈旧性眼底出血患者23只眼，使用Topcon 50IA 眼底血管造影机以荧光素眼底血管造影（FFA）状态的蓝光为激发光，分别采集4例陈旧性眼底出血患者自身荧光的黑白图片和16例患者自身荧光的彩色图像。分别使用海德堡视网膜血管造影机（HRA 2）488 nm和795 nm扫描激光作为激发光，观察3例陈旧性眼底出血患者的自身荧光。 结果 Topcon 50IA 眼底血管造影机蓝光激发下使用黑白方式记录4例陈旧性眼底出血患者眼底自身荧光，可发现自身荧光较强；彩色方式纪录16例患者自身荧光显示自身荧光为红色。3例陈旧性眼底出血患者眼底经蓝色激光（488 nm）和近红外激光（795 nm）激发，也可出现自身荧光，但是其范围和强度有所不同。 结论 陈旧性眼底出血的成份复杂，不同波长的光线可以激发陈旧性眼底出血产生出不同波长的自身荧光。     

周边自身荧光检查对孔源性视网膜脱离巩膜扣带手术的评估

眼底自身荧光(FAF)主要来源于视网膜色素上皮(RPE)细胞内堆积的代谢产物脂褐质,是活体条件下评价RPE活性与形态学改变的重要检测下具.作为一种无损伤、可重复、简便快捷的检测手段,FAF结合其他眼底形态与功能检测方法,可从RPE结构和功能变化的角度为部分常见眼底疾病提供辅助诊断依据.在逐步认识各种眼底疾病FAF表现特征的同时,对FAF结果量化分析,充分利用FAF以及其他检测手段的优势互补,从发生机制上加深眼底疾病FAF表现特征的认识,积极拓展其合理和独有的临床应用领域,将有助于对眼底疾病内在病理机制获得更新的认识,指导获得更为合理有效的诊疗经过.

Abstract：

Fundus autofluorescence (FAF) relies primarily on the presence of accumulated lipofuscin in the retinal pigment epithelium (PRE) cells. It has emerged as a valuable tool to detect and evaluate the viability and structural changes of the RPE in live. As a non-invasive, repeatable, simple and efficient means of detection. FAF imaging can provide information of RPE structure and function to assistant the diagnosis of many retinal diseases with other conventional fundus imaging technologies. With quantitative analysis and complementary analysis with other fundus imaging technologies, the FAF features of different retinal diseases will be further understood. This knowledge will not only extend the reasonable and unique clinical applications of FAF, but also will contribute to the understanding the pathogenesis and improving the treatment of many retinal diseases.     

中心性浆液性脉络膜视网膜病变眼底自身荧光的影像特征

目的 观察中心性浆液性脉络膜视网膜病变（CSC）眼底自身荧光（AF）的影像特征。方法 采用海德堡激光扫描眼底造影系统和Kowa眼底彩色照相系统，对72例CSC患者的85只患眼进行眼底彩色照相、无赤光照相、荧光素眼底血管造影（FFA）检查，使用488 nm波长激光获取灰白的AF图像并与眼底彩色照相、无赤光照相及FFA图像进行对比分析。 结果 85只患眼中，CSC病灶AF表现为单发的弱AF12例14只眼，占16.5%；弱AF中包含较弥漫的强AF病灶32例39只眼。占45.9%；弱AF和斑点状AF相连的复合病灶22例25只眼，占29.4%；后极部局部斑点状密集或散在强弱AF5例7只眼，占82%。FFA荧光素渗漏点或异常荧光与异常AF相对应者54例60只眼，占70.6%；眼底改变和FFA、眼底AF变化不一致者18例25只眼，占29.4%。不同病程的CSC病灶AF表现不一，发病期表现为单发的盘状弱AF池，以及弱AF池内或外斑点状强AF复合病灶；慢性迁延期可见斑点状强弱AF交织，范围大小不等的多发病灶。 结论 C的AF以单发的弱AF池、强弱AF交织的复合病灶以及黄斑区AF多发病灶多见；AF检查结合眼底彩色照相、FFA检查，可以对CSC的影像观察起到相互补充的作用。     

儿童遗传性视网膜疾病的眼底自身荧光表现

目的 观察儿童遗传性视网膜疾病的眼底自身荧光(FAF)特征.方法 回顾性分析22例临床资料完整、年龄5～14岁之问的遗传性视网膜疾病患儿的FAF检查结果.其中,Best卵黄样病变8例16只眼,Stargardt病3例6只眼,视锥细胞营养不良3例6只眼,原发性视网膜色素变性(RP)5例10只眼,X连锁青少年型视网膜劈裂症3例6只眼.仔细询问现病史及家族史,行视力、裂隙灯显微镜眼前节检查,间接眼底镜检查,彩色眼底像和FAF照相,其中部分患儿接受了荧光素眼底血管造影(FFA)、视网膜电流图、眼电图、光相干断层扫描检查.对上述患儿的FAF结果特征进行归纳总结,并与其眼底照相和/或FFA结果进行比较分析.结果 3例Stargardt病患儿的6只眼及3例视锥细胞营养不良患儿的6只眼FAF检查显示黄斑区可见对称性的圆形、近圆形弱荧光或荧光缺如区,2例视锥细胞营养不良患儿的4只眼及1例Stargardt病患儿的2只眼可见弱荧光或荧光缺如区外缘环以强荧光;Best卵黄样病变患儿黄斑区可见一个强度均匀或不均匀的强FAF病灶;RP患儿后极部视网膜FAF增强,黄斑区周围可见宽度不等的环形强荧光带,拱环区FAF正常;3例X连锁青少年型视网膜劈裂症患儿中5只眼中心凹部位FAF检查可见蜂窝或颗粒状强荧光.结论 Stargardt病及视锥细胞营养不良患儿黄斑区为近圆形弱荧光,部分病变区外缘环以强荧光;Best卵黄样病变患儿黄斑区为强度均匀或不均匀的强FAF病灶;RP患儿后极部视网膜FAF增强,拱环区FAF正常,黄斑区周围可见宽度不等的环形强荧光带;X连锁青少年型视网膜劈裂症患儿中心凹部位为蜂窝或颗粒状强荧光.

Abstract：

Objective To observe the autofluorescence (AF) manifestation in children with hereditary retinal diseases. Methods The clinical data of 22 children (aged from 5 to 14 years) with hereditary retinal diseases were retrospectively analyzed. There were 8 children (16 eyes) with Best vitelliform macular dystrophy, 3 children (6 eyes) with Stargardt macular dystrophy, 3 children (6 eyes) with macular cone dystrophy, 5 children (10 eyes) with primary retinitis pigmentosa, and 3 children (6 eyes) with X-linked juvenile retinoschisis. The routine clinical examinations included present history, family history, visual acuity, silt-lamp microscopy, indirect ophthalmoscopy, color fundus photography and fundus autofluorescence angiography (FAF). Some patients received fundus fluorescein angiography (FFA),electroretinogram (ERG), electrooculogram (EOG), and ocular coherence tomography (OCT). The characteristics of AF in all the children were analyzed, and were compared with the images of color fundus and/or FFA. Results Symmetry round macular fluorescent weak or absent area was found in all Stargardt disease and cone dystrophy. Weak AF area with surrounded circular increased AF was found in 2 children (4 eyes) with cone dystrophy and 1 child (2 eyes) with Stargardt macular dystrophy. A central round area with regular or irregular intense AF was observed in Best vitelliform macular dystrophy. RP children showed increased AF out of the macular region. Cellular or granular strong AF was found in the fovea of 3 children (5 eyes) with X-linked juvenile retinoschisis. Conclusion The children with hereditary retinal diseases had special AF changes.     

周边部视网膜格子样变性区的自身荧光特征

视网膜格子样变性是视网膜周边部退行性变的一种表现,发病机制不详[1].以往对格子样变性的认识和研究大都为形态学和组织学方面[2-4].眼底自身荧光(AF)作为一种快速无创的眼底检查,可以反映活体内视网膜色素上皮(RPE)功能和代谢的改变[5].     

Purtscher视网膜病变的眼底荧光血管造影

作者观察了Purtscher视网膜病变的眼底荧光血管造影表现，发现该病的眼底表现主要是后极部视网膜灰白色水肿，眼底荧光血管造影表现为大片视网膜毛细管无灌注区。提示本病的发病机制主要是视网膜小动脉阻塞． （中华眼底病杂志，1996，12：188-189）     

家族性渗出性玻璃体视网膜病变的荧光素眼底血管造影特征及其诊断价值

目的 观察家族性渗出性玻璃体视网膜病变(FEVR)的荧光素眼底血管造影(FFA)特征,评价FFA对FEVR的诊断价值.方法 经临床检查诊断为FEVR的患儿34例68只眼及其父母64名128只眼纳入本研究.所有受检者均采用裂隙灯显微镜检查眼前节、间接检眼镜检查眼底.患儿同时应用RetcamⅡ视网膜成像系统检查眼底,患儿父母同时行最佳矫正视力检查.根据以上检查表现,对患儿及其父母行FEVR分期.采用RetcamⅡ视网膜成像系统在全身麻醉状态下对患儿行FFA检查;用海德堡HR2眼底血管造影设备对患儿父母行常规FFA检查.观察患儿及其父母不同分期FEVR的FFA特征.结果 患儿68只眼中,正常者3只眼,占4.41%;1期4只眼,占5.88%;2期7只眼,占10.29%;3期2只眼,占2.94%;4期8只眼,占11.76%;5期44只眼,占64.71%.患儿父母128只眼中,正常者74只眼,占57.81%;1期51只眼,占39.84%;2期1只眼,占0.78%;A;5期2只眼,占1.56%.患儿FFA检查发现,1期主要表现为视网膜血管发育不完全,未发育至周边即终止,视网膜周边无灌注.2期在1期FFA表现的基础上,在视网膜异常吻合处有新生血管形成和(或)视网膜渗出异常.3期在2期FFA表现的基础上,存在玻璃体牵引诱发的周边视网膜脱离,但未累及黄斑.4期主要表现为累及黄斑的视网膜脱离.5期主要表现为全视网膜脱离.患儿父母FFA检查发现,1期主要表现为视网膜血管近赤道部突然中止,出现周边无灌注区.2期在1期FFA表现的基础上,在视网膜无灌注区附近有动静脉短路和新生血管形成和(或)视网膜下渗漏.5期主要表现为眼球萎缩.结论 不同分期的FEVR存在不同程度的FFA特征表现;FFA检查可以发现FEVR患者的早期眼底改变,具有重要的诊断价值.

Abstract：

Objective To investigate the characteristics and diagnostic value of fundus fluorescein angiography(FFA)for familial exudative vitreoretinopathy(FEVR).Methods 34 children(68 eyes)with FEVR and 64 parents(1 28 eyes)were included.All the clients were received examinations of slit-lamp biomicroscopy and indirect ophthalmoscopy.Meanwhile the children were examined by Retcam Ⅱ,the best corrected visual acuity of parents were recorded.The children and their parents were classified according to the ocular findings.Among 68 eyes of children,3 eyes(4.41% )were normal,4 eyes(5.88% )were in stage 1,7 eyes(10.29% )were in stage 2,2 eyes(2.94% )were in stage 3,8 eyes(11.76% )were in stage 4 and 44 eyes(64.71% )were in stage 5.Among 128 eyes of parents,74 eyes(57.81% )were normal,51eyes(39.84% )were in stage 1,1 eyes(O.78% )were in stage 2 and 2 eyes(1.56% )were in stage 5.FFA was performed on the children with RetcamⅡunder anesthesia and on the parents with HR2 in order to observe the FFA characteristics in different stage.Results FFA characte ristics in children included uncompleted vascularization of the periphery,peripheral avascular zone(stage 1);neovascularization and/or peripheral subretinal and intraretinal exudation(stage 2);subtotal retinal detachment with attached foyea (stage 3);subtotal retinal detachment with detached foyea(stage 4)and total retinal detachment(stage 5).FFA characteristics in parents included abrupt cessation of the peripheral retinal capillary network and a peripheral avascular zone(stage 1); abnormal peripheral arteriovenous shunts, neovascularization or exudation(stage 2)and atrophia bulbi(stage 5).Conclusions FEVR in different stage has different FFA characteristics.FFA plays an important role in early diagnosis of FEVR.     

家族性渗出性玻璃体视网膜病变的荧光素眼底血管造影特征及其诊断价值

Objective To investigate the characteristics and diagnostic value of fundus fluorescein angiography(FFA)for familial exudative vitreoretinopathy(FEVR).Methods 34 children(68 eyes)with FEVR and 64 parents(1 28 eyes)were included.All the clients were received examinations of slit-lamp biomicroscopy and indirect ophthalmoscopy.Meanwhile the children were examined by Retcam Ⅱ,the best corrected visual acuity of parents were recorded.The children and their parents were classified according to the ocular findings.Among 68 eyes of children,3 eyes(4.41% )were normal,4 eyes(5.88% )were in stage 1,7 eyes(10.29% )were in stage 2,2 eyes(2.94% )were in stage 3,8 eyes(11.76% )were in stage 4 and 44 eyes(64.71% )were in stage 5.Among 128 eyes of parents,74 eyes(57.81% )were normal,51eyes(39.84% )were in stage 1,1 eyes(O.78% )were in stage 2 and 2 eyes(1.56% )were in stage 5.FFA was performed on the children with RetcamⅡunder anesthesia and on the parents with HR2 in order to observe the FFA characteristics in different stage.Results FFA characte ristics in children included uncompleted vascularization of the periphery,peripheral avascular zone(stage 1);neovascularization and/or peripheral subretinal and intraretinal exudation(stage 2);subtotal retinal detachment with attached foyea (stage 3);subtotal retinal detachment with detached foyea(stage 4)and total retinal detachment(stage 5).FFA characteristics in parents included abrupt cessation of the peripheral retinal capillary network and a peripheral avascular zone(stage 1); abnormal peripheral arteriovenous shunts, neovascularization or exudation(stage 2)and atrophia bulbi(stage 5).Conclusions FEVR in different stage has different FFA characteristics.FFA plays an important role in early diagnosis of FEVR.     

家族性渗出性玻璃体视网膜病变的荧光素眼底血管造影特征及其诊断价值

Objective To investigate the characteristics and diagnostic value of fundus fluorescein angiography(FFA)for familial exudative vitreoretinopathy(FEVR).Methods 34 children(68 eyes)with FEVR and 64 parents(1 28 eyes)were included.All the clients were received examinations of slit-lamp biomicroscopy and indirect ophthalmoscopy.Meanwhile the children were examined by Retcam Ⅱ,the best corrected visual acuity of parents were recorded.The children and their parents were classified according to the ocular findings.Among 68 eyes of children,3 eyes(4.41% )were normal,4 eyes(5.88% )were in stage 1,7 eyes(10.29% )were in stage 2,2 eyes(2.94% )were in stage 3,8 eyes(11.76% )were in stage 4 and 44 eyes(64.71% )were in stage 5.Among 128 eyes of parents,74 eyes(57.81% )were normal,51eyes(39.84% )were in stage 1,1 eyes(O.78% )were in stage 2 and 2 eyes(1.56% )were in stage 5.FFA was performed on the children with RetcamⅡunder anesthesia and on the parents with HR2 in order to observe the FFA characteristics in different stage.Results FFA characte ristics in children included uncompleted vascularization of the periphery,peripheral avascular zone(stage 1);neovascularization and/or peripheral subretinal and intraretinal exudation(stage 2);subtotal retinal detachment with attached foyea (stage 3);subtotal retinal detachment with detached foyea(stage 4)and total retinal detachment(stage 5).FFA characteristics in parents included abrupt cessation of the peripheral retinal capillary network and a peripheral avascular zone(stage 1); abnormal peripheral arteriovenous shunts, neovascularization or exudation(stage 2)and atrophia bulbi(stage 5).Conclusions FEVR in different stage has different FFA characteristics.FFA plays an important role in early diagnosis of FEVR.     

中心性浆液性脉络膜视网膜病变眼底影像检查特征对比观察

目的 观察探讨中心性浆液性脉络膜视网膜病变(CSC)影像检查特征及其意义.方法 18例临床确诊的CSC患者的21只眼纳入观察.其中,男性12例14只眼,女性6例7只眼.年龄26～47岁,平均年龄(39.1±5.4)岁.急性CSC 9例11只眼,慢性CSC 7例7只眼,复发性CSC 2例3只眼.采集患眼的眼底彩色像以及眼底红外(IR)、自身荧光(FAF)、红外自身荧光(NIR-AF)、荧光素眼底血管造影(FFA)联合吲哚青绿血管造影(ICGA)的图像,对比观察其影像特征及各种影像特征的相互关系.结果 21只患眼的彩色眼底像均可见呈圆形的黄斑区浆液性视网膜神经上皮脱离.在IR像中,21只眼的浆液性视网膜神经上皮脱离区均呈弱反光区.其中,10只眼的弱反光区内夹杂斑驳状强反光斑点,与FFA检查所示渗漏部位一致.在FAF像中,15只眼的视网膜神经上皮脱离区表现为弱荧光;6只眼的视网膜神经上皮脱离区表现为较强荧光.其中,14只眼的FFA检查所示渗漏灶对应处或周边结构可见弱或强荧光,7只眼的FFA检查所示渗漏灶未见异常荧光.3只急性CSC患眼的FAF像上可见视网膜神经上皮脱离区下方大片散在的点状强荧光,这些点状强荧光在ICGA检查期间始终表现为弱荧光.在NIR-AF像中,15只眼的浆液性视网膜神经上皮脱离区呈弱荧光;6只眼的浆液性视网膜神经上皮脱离区呈相对强荧光.其中,14只眼的FFA检查所示渗漏灶对应处呈强或弱或斑驳状荧光,7只眼的FFA检查所示渗漏灶未见异常荧光.在FFA检查时,21只眼均可见荧光渗漏.在药物注射1～5 min的ICGA像中,8只眼表现为区域性脉络膜充盈迟缓;13只眼表现为区域性脉络膜静脉扩张.FFA联合ICGA像中,6只眼在ICGA像中显示的病灶数比在FFA像中多;3只眼FFA检查未显示异常的部位在ICGA晚期像中可见明显的斑片状弱荧光.结论 CSC在IR、FAF及NIR-AF上有其特征性的眼底影像表现.FFA为CSC的主要检查方法,ICGA可以更好的揭示其脉络膜的损害;IR、FAF及NIR-AF对于渗漏灶的检出不如FFA及ICGA.     

急慢性中心性浆液性脉络膜视网膜病变的自身荧光和频域光相干断层扫描图像特征

[目的]观察急慢性中心性浆液性脉络膜视网膜病变(CSC)的自身荧光(AF)和频域光相干断层扫描( OCT)图像特征.[方法]经裂隙灯显微镜、彩色眼底照相、荧光素眼底血管造影(FFA)、吲哚青绿血管造影检查确诊为CSC的67例患者73只眼纳入研究.所有患者同时行AF及频域OCT检查.根据患者临床及FFA表现,将其分为急性、慢性CSC 2种类型,分别为37例37只眼、30例36只眼.根据黄斑区神经上皮脱离区的AF表现将其分为单纯减弱型、单纯增强型及混合改变型3种类型.根据频域OCT检查显示的神经上皮脱离区内外节的表现将其分为外节保存完整型、外节保存不全型及外节萎缩型3种类型.观察急慢性CSC患者的AF及OCT图像特征.[结果]AF检查发现,急性CSC 37只眼中,单纯减弱型AF19只眼,占51.35％;单纯增强型AF 18只眼,占48.65％.慢性CSC36只眼中,单纯减弱型AF 2只眼,占5.56％;单纯增强型AF 16只眼,占44.44％;混合改变型AF 18只眼,占50.00％.急慢性CSC患者3种AF表现的眼数比较,差异有统计学意义(x2=31.872,P=0.000).频域OCT检查发现,急性CSC 37只眼中,外节保存完整型15只眼,占40.54％;外节保存不全型18只眼,占48.65％;外节萎缩型4只眼,占10.81％.慢性CSC 36只眼中,外节保存完整型5只眼,占13.89％;外节保存不全型17只眼,占47.22％;外节萎缩型14只眼,占38.89％.急慢性CSC患者3种OCT表现的眼数比较,差异有统计学意义(x2=i0.572,P=0.005).[结论]急性CSC的AF表现以单纯减弱型为主,慢性CSC的AF表现以混合改变型为主.急性CSC的OCT表现以外节保存不全型和外节保存完整型为主,慢性CSC的OCT表现以外节保存不全型和外节萎缩型为主.     

中心性浆液性脉络膜视网膜病变的吲哚青绿和荧光素眼底血管造影

目的 观察中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)的吲哚青绿血管造影(indocyanine green angiography,ICGA)特征。 方法 用共焦激光扫描眼底血管造影仪对70例CSC患者进行荧光素眼底血管造影(fundus fluorescein angiography,FFA)与ICGA同步检查。 结果 79只眼FFA检查有视网膜色素上皮(retinal pigment epithelium,RPE)渗漏。ICGA检查23只眼的脉络膜血管充盈迟缓;79只患眼有脉络膜血管扩张充血;78只眼的RPE渗漏处有脉络膜血管的通透性增高;27只对侧健眼有同样的改变;19只患眼和6只健眼有RPE脱离;21只眼有RPE的色素脱失、萎缩和/或带状萎缩。 结论 脉络膜血管异常是CSC的基本ICGA特征。(中华眼底病杂志,2000,16:14-16)     

充分发挥激光眼底照相的临床应用价值,不断提升眼底病诊断水平

激光眼底照相技术以激光共焦扫描检眼镜为成像基础,叠加两种或三种激光分别获取视网膜不同层面的图像,并以电脑合成一张综合视网膜多层面叠加信息的伪彩眼底像。因其免散瞳、成像快、操作简便等特点,患者配合度高,广泛应用于门诊眼底预检查、大样本的流行病学筛查等,在多种眼底疾病诊疗中均有很好的临床和科研应用价值。但目前国内尚缺乏激光眼底照片的阅片统一标准。因此,正确识别激光眼底照相上的常见眼底病变,并将分层阅片的方法进行总结与推广是十分必要的。此外,充分发挥激光眼底照相对眼底病变分层定位诊断的价值,合理选择激光眼底照相与OCT、OCT血管成像、FFA、ICGA及超声等其他眼底影像技术的联合,最大程度充分发挥其应用价值,才能更好地服务于临床。     

多发性一过性白点综合征的临床和眼底血管造影特征

目的 观察多发性一过性白点综合征(MEWDS)的临床表现和眼底血管造影特征.方法 经荧光素眼底血管造影(FFA)和吲哚青绿血管造影(ICGA)检查确诊的40例MEWDS患者40只眼的临床资料纳入研究.分析其临床特征、FFA和ICGA改变.结果 40例患者均为单眼发病,其中,男性12例,女性28例;年龄16～64岁,平均年龄29.4岁.初诊时最佳矫正视力0.1～1.0,平均最佳矫正视力0.82.眼底检查均可见多个灰白色圆形斑点状病灶,直径约100～500 μm,边界欠清晰;位于视网膜深层或视网膜色素上皮层.部分患者伴有轻度玻璃体混浊.FFA检查早期发现所有患者在白点状病灶对应部位可见有圆形或环形强荧光斑,晚期着染;18例患者出现视盘强荧光,并伴有视盘周围静脉渗漏;7例患者出现黄斑区强荧光斑.ICGA造影早期可见到视网膜后极部及周边部弱荧光斑,晚期持续存在,无明显渗漏;与FFA 检查比较,其弱荧光斑数目多且明显.所有患者的主诉症状均在6～8周内消失.结论 MEWDS患者眼底表现为多发性灰白色点状病灶;FFA早期表现为圆形强荧光和视网膜血管异常;ICGA检查可清晰显示视网膜后极部及中周部弱荧光斑,病灶数目明显多于FFA检查和检眼镜检查所见.

Abstract：

Objective To observe the clinical and fundus angiography characteristics of multiple evanescent white dot syndrome (MEWDS). Methods Forty eyes of 40 patients (12 males/28 females) with MEWDS, diagnosed by fundus fluorescein angiography (FFA) or indocyanine green angiography (ICGA)were enrolled. All cases were unilateral. The age was ranged from 16 to 64 years old, with a mean of 29.4years. The initial average corrected vision was ranged from 0.1 to 1.0, with a mean of 0.82. The characteristics of clinical manifestations, the features of FFA and ICGA were analyzed. Results Multiple gray-white dots (100-500 μm) were found throughout the posterior pole and the mid-periphery areas. The lesions were at the depth of outer retina and retinal pigment epithelium layers. Some patients presented with mild vitreous opacity. FFA showed round or ring hyper-fluorescence spots at the early stage and tissue staining at the late stage, corresponding to the gray-white dots. Hyper-fluorescence spots and leakages at the retinal veins near optic disk were seen in 18 patients. The hyper-fluorescence spots near macular area were found in 7 patients. ICGA showed that numerous dark hypo-fluorescent dots in the mid-periphery and posterior pole at the early stage and no leakage at the late stage. ICGA detected more lesions than FFA. All of the patients were recovered without any visual complications within 6-8 weeks. Conclusions MEWDS patients have multiple fundus gray-white dots, and hyper-fluorescence and the abnormal retinal vessels by FFA, and multiple weak hypo-fluorescent spots throughout the posterior pole and the mid-periphery areas clearly on ICGA. The ICGA showed more lesions than the ophthalmoscope and FFA examination.     

眼底多模式影像的进展及其现阶段存在的问题

眼底疾病认知的更新离不开眼底多模式影像的快速发展。特别是近年来广角及超广角眼底照相、超广角荧光素眼底血管造影、吲哚青绿血管造影、眼底自身荧光及光相干断层扫描血管成像等检查的应用,让临床医师对周边部视网膜病变的观察更为直接;自适应光学及荧光寿命成像检眼镜的应用,使临床医师在细胞及代谢层次对眼底疾病有了更进一步的认识。多模式影像之间相辅相成,可以从不同角度、不同层次反映疾病的病变特征。同时,眼底影像的数字化及智能化也在快速发展。但是如何正确使用多模式影像,如何正确理解人工智能在眼科影像的应用以及如何从影像中归纳总结,也是每位眼科医生需要思考的问题。     

渗出型老年性黄斑变性与息肉状脉络膜血管病变眼底形态学的对比分析

目的 观察渗出型老年性黄斑变性（AMD）与息肉状脉络膜血管病变（PCV）眼底表现的异同。 方法 回顾性分析渗出型AMD患者123例137只眼及PCV患者42例48只眼的眼底彩色像、荧光素眼底血管造影（FFA）和吲哚青绿血管造影（ICGA）检查资料。 结果 137只渗出型AMD患眼中，FFA显示16只眼为典型脉络膜新生血管（CNV），占11.7%；隐匿型CNV121只眼，占88.3%。隐匿型CNV患眼中，42只眼ICGA检查可见“热点状”（hot spots）荧光，占34.7%；74只眼表现为后期斑状强荧光，占61.2%；2只眼CNV与PCV共存 ，占1.7%。48只PCV眼中，7只眼的眼底彩色像可见特有的视网膜下橘红色结节样病灶，占14.6%； 2只眼FFA即显示出分 支状脉络膜血管网及息肉状病灶，占4.2%； 36只眼ICGA显示异常分支的脉络膜血管网及其末梢的息肉状扩张灶，占75.0%；12只眼ICGA显示多个息肉状扩张灶而未见伴有分支状脉络膜血管网，占25.0%。息肉状病灶呈葡萄串样外观者16只眼，占33.3%；，呈多个孤立并存者32只眼，占66.7%。造影后期部分息肉状病灶染料渗漏或染色，部分呈息肉状病灶中心为弱荧光，周围环状染色的“冲刷现象”。 结论 渗出型AMD与PCV不同的ICGA表现及PCV眼底特征性的视网膜下橘红色结节样病灶有助于两者的诊断与鉴别诊断.（中华眼底病杂志，2004，20：307-309）