吲哚青绿血管造影在老年黄斑变性脉络膜新生血管诊治中的应用

由于吲哚青绿血管造影（ＩＣＧＡ）弥补了眼底荧光血管造影（ＦＦＡ）的不足,医生能更清晰地观察到脉络膜血液循环情况。本文就ＩＣＧＡ在诊断老年黄斑变性（ＡＭＤ）患者脉络膜新生血管（ＣＮＶ）病变中的应用,并在ＩＣＧＡ指导下进行激光,放射等疗法方面作一综述。     

脉络膜黑色素瘤荧光素和吲哚青绿眼底血管造影五例

脉络膜黑色素瘤是较常见的眼内恶性肿瘤 ,其眼底表现及荧光素眼底血管造影特征已有文献报导 ,而吲哚青绿血管造影 (ｉｎｄｏｃｙａｎｉｎｅｇｒｅｅｎａｎｇｉｏｇｒａｐｈｙ,ＩＣＧＡ)报道较少[1] ,笔者最近遇到 5例脉络膜黑色素瘤患者 ,同时行荧光素眼底血管造影 (ｆｕｎｄｕｓｆｌｕｏｒｅｓｃｅｎｃｅａｎｇｉｏｇｒａｐｈｙ,ＦＦＡ)和ＩＣＧＡ检查 ,现将检查结果报告如下。一、病例简介例 1　 女 ,43岁。左眼视物不清 1年 ,于 1999年 3月就诊。眼部检查 :视力右眼 1 2 ;左眼 0 1,不能矫正。双眼前节及右眼底正常。左眼底视乳头颞上方…     

吲哚青绿脉络膜血管造影Ⅰ.基本情况

眼底镜的发明和眼底荧光血管造影(fundus fluorescein angiography,FFA)的引入,使得对眼底结构和功能的认识及很多眼底病的诊治向前迈了一大步.但由于脉络膜血管被色素上皮及自身色素遮挡,观察困难,对血管构筑和血流动力学及在眼病中的地位和作用了解不多.以前对脉络膜循环的了解多基于离体铺版或血管铸型研究或FFA,这些研究在一定程度上提示了脉络膜血管的构筑,但临床上却需要一种能直接观察循环的动态方法以解决临床实际问题.70年代以来以Flower为代表的研究者们引入吲哚青绿脉络膜血管造影(indocyanine green choroidal angiography,ICGCA)^[1]使人们能更清楚而直观地了解脉络膜血循环动态情况,随着技术的不断进步和经验的积累,ICGCA将逐步被人们所认识,ICGCA在一些发达国家已较多应用于临床.兹将ICGCA的基本情况、临床应用及技术新进展分三篇介绍。 （中华眼底病杂志，1994，10：253-255）     

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。     

吲哚青绿脉络膜血管造影Ⅲ.技术新进展

吲哚青绿脉络膜血管造影Ⅲ．技术新进展陈有信，董方田综述张承芬审校（上接１９９４年第１０卷第４期第２５６页）１吲哚青绿脉络膜血管录像造影（ｉｎｄｏｃｙａｎｉｎｅｇｒｅｅｎｃｈｏｒｏｉｄａｌｖｉｄｅｏａｎｇｉｏｇｒａｐｈｙ）［１，２］８０年代，录相技术日...     

吲哚青绿血管造影指导光凝治疗老年性黄斑变性脉络膜新生血管

老年性黄斑变性 (aging- macular degeneration,AMD)的脉络膜新生血管 (choroidal neovascularization,CNV)是引起视力下降的重要原因 [1 ]。吲哚青绿血管造影 (indocyanine green an-giography,ICGA)可有效发现 CNV及供养血管和热点 ,为准确地激光光凝治疗提供了依据 [2 - 4]。我们在 ICGA指导下用多波长氪离子激光光凝 AMD的 CNV4例 6只眼 ,报告如下。1　对象和方法自 1999年 11月至 2 0 0 0年 12月诊断为渗出型 AMD伴有CNV患者 4例 6只眼 ,其中男性 2例 ,女性 2例。年龄 6 0～ 72岁 ,平均年龄 6 8.5岁。AMD的诊断标准参照 1…     

吲哚青绿脉络膜血管造影Ⅱ.临床应用

吲哚青绿脉络膜血管造影Ⅱ．临床应用陈有信，叶俊杰综述张承芬审校一、造影设备及操作［１，２］１．设备：基本设备应包括一台眼底照相机，摄速要达１０～３０帧／秒；电视监视器；电子装置包括自动计时及自动快门装置；滤光片用以去除波长在７００～７３０和８５０～１...     

激光扫描眼底镜同时荧光血管造影和吲哚青绿血管造影

眼底荧光血管造影 (ＦＦＡ)和吲哚青绿血管造影 (ＩＣＧＡ)是检查和记录视网膜、脉络膜血管状态的重要诊断技术。现代的眼底荧光血管造影在 6 0年代就应用于临床 ,人们已经有很清楚的认识 ;而吲哚青绿血管造影是 90年代中期才开始应用 ,虽然目前ＦＦＡ、ＩＣＧＡ的检查在各地已     

视网膜色素变性的眼底荧光血管造影与吲哚青绿血管造影比较

目的　观察视网膜色素变性患者的脉络膜循环特征 ,探讨视网膜色素变性的发病因素。方法　 14例(2 8眼 )视网膜色素变性患者按常规方法行眼底荧光血管造影和吲哚青绿脉络膜血管造影。结果　 14例 (2 8眼 )眼底荧光血管造影动脉显影时间 12 .92± 2 .14s。造影早期脉络膜背景荧光暗淡 ,周边视网膜可见细点状色素上皮萎缩透见荧光及色素斑块遮蔽荧光 ,中晚期周边及后极部视网膜荧光素渗漏 ,呈斑片状强荧光。吲哚青绿造影动脉显影时间 13.86± 2 .73s。造影显示周边及后极部脉络膜大片毛细血管无灌注。结论　 FFA和 ICGA造影结果表明视网膜色素变性患者脉络膜毛细血管萎缩造成的脉络膜微循环障碍可能是导致视网膜色素上皮及视网膜感光细胞营养不良的因素之一。     

老年性黄斑变性的吲哚青绿和荧光素眼底血管造影

目的 探讨眼底荧光素血管造影(fundus fluorescein angiography,FFA)和吲哚青绿血管造影(indocyanine green angiography,ICGA)在老年性黄斑变性(age-related macular degeneration,AMD)患者中的临床应用.方法 对AMD患者375例742只眼的FFA和ICGA检查资料进行分析总结.结果 在所有患者中,萎缩型504只眼(67.9%),渗出型238只眼(32.1%).在同步进行FFA和ICGA检查的渗出型AMD93只眼中,FFA检查发现典型性CNV 14只眼(15.1%),隐匿性CNV 79只眼(84.9%);ICGA检查发现边界清楚的CNV48只眼(51.6%),两者相比差异具有统计学意义(x2=27.97,P＜0.01).ICGA检查发现CNV的供养血管6只眼(6.5%),均位于中心凹旁或中心凹外.在发现边界清楚CNV的48只眼中,中心凹下CNV29只眼(60.4%),中心凹旁CNV 12只眼(25.0%),中心凹外CNV7只眼(14.6%).结论 与FFA相比,ICGA可以更加准确地显示CNV,发现CNV的供养血管,对AMD的临床诊断和治疗具有更重要的指导意义.     

Characteristics of Indocyanine Green Angiography in Exudative Age—related Macular Degeneration

Objective: To observe the characteristics of indocyanine green angiography (ICGA) in exudative age-related macular degeneration (AMD).Methods: Thirty-one cases (39 eyes) were diagnosed as exudative AMD by ocular examination, fundus color photography, fundus fluorescein angiography (FFA) and ICGA. Their ages ranged from 50 to 82 years and visual acuities from FC/30cm to 0. 7. We analyzed and compared the characteristics of ICGA and FFA in these patients. Results: Of 26 eyes with occult choroidal neovascularization (CNV) by FFA, 15 (57. 7% ) had classic CNV by ICGA. Of 4 eyes with serous retinal pigment epithelial detachment (FED) without CNV by FFA, 1 had serous FED with classic CNV by ICGA. The hyperfluorescence of the scar staining was detecfed by ICGA. Conclusion ? ICGA adds clinically useful information and is an important adjunct in the evaluation, classification, and laser treatment of patients with occult CNV in AMD. Eye Science 1999; 15: 156 - 161.     

Ultra-Widefield Indocyanine Green Angiography Reveals Patterns of Choroidal Venous Insufficiency Influencing Pachychoroid Disease

PurposeTo compare patterns of choroidal venous drainage in eyes with pachychoroid disease to those of healthy subjects using ultra-widefield indocyanine green angiography (UWF ICGA).MethodsPatients with pachychoroid disease and healthy controls were recruited at two referral centers. UWF ICGA images were used to evaluate the proportion of the postequatorial fundus drained by major vortex vein systems in each quadrant and to study the incidence and topography of choroidal vascular hyperpermeability (CVH) and intervortex venous anastomoses. Widefield swept-source optical coherence tomography (SS-OCT) was used to evaluate choroidal thickness at the posterior pole in eyes with pachychoroid disease.ResultsFifty-two pachychoroid eyes and 26 healthy eyes were evaluated. Eyes with pachychoroid disease showed a significant within-subject variance in the proportion of the postequatorial fundus drained by each vortex vein system (range, 4.1%–48.1%; P < 0.0001) that was not seen in controls (range, 17.3%–31.7%; P = 0.11). CVH was present in all pachychoroid disease eyes and three of 26 controls. Intervortex venous anastomoses were present in 46 of 52 pachychoroid disease eyes and nine of 26 control eyes. Vortex vein systems with large drainage areas showed greater density of CVH spots. SS-OCT demonstrated asymmetric choroidal drainage in the macula of 59% of pachychoroid eyes. CVH and intervortex venous anastomoses were more prominent in areas showing maximal choroidal thickness.ConclusionsIn eyes with pachychoroid disease, imbalanced choroidal venous drainage with congestion of specific vortex vein systems may contribute to a state of choroidal venous insufficiency characterized by regional choroidal thickening, CVH and remodeling of venous drainage routes.     

从吲哚青绿血管造影表现分析中心性浆液性脉络膜视网膜病变

目的:通过分析中心性浆液性脉络膜视网膜病变(Central Serous Chorioretinopathy,CSCR)的吲哚青绿血管造影(Indocyanine Green Angiography,ICGA)特征,探讨该病的病理特点及治疗机理。方法:使用海德堡血管造影仪对35例临床诊断为CSCR患者进行ICGA及眼底荧光血管造影(FFA)同步分析,解释和讨论造影结果。结果:35例病例中,有29例(83％)在ICEA中发现的病灶超过FFA所见病灶数,25例(71.4％)为双眼,所有FFA的病灶处均有ICGA改变,且ICGA所见病灶范围大于FFA病变。结论:脉络膜通透性改变是中浆的早期改变,由此引起其上方视网膜色素上皮(RPE)功能失代偿和缺损可能是中浆的主要发病机制。中浆的激光和药物治疗效果和原理需要进一步探讨。眼科学报1999;15:81—84。     

Changes of Indocyanine Green and Fluorescein Angiography in Multiple Evanescent White-dot Syndrome： A Case Report

Purpose:To study the clinicopathological change on "Multiple Evanescent White-dot Syndrome (MEWDS)" through fundus angiogrphy analyses.Methods:Examing the case with fluorescein angiography (FFA) and indocyanine green angiography(ICGA), visual field and following up for 15 months.Results:There exist multiple white dots in the fundus photo and angiography. The changes on ICGA maintain longer than fundus photo and FFA. Papille may be edematous and macula could present with special hypofluorescent flecks.Conclusions:MEWDS has specific angiographic features. Its pathological changes involve deep retinal pigment epithelium(RPE) as well as choroidal capillaries. The prognosis of the visual acuity for MEWDS is very good. Eye Science 2003;19:171-173.     

Correlation Between Indocyanine Green Angiographic Findings and Histopathology of Polypoidal Choroidal Vasculopathy

Purpose To analyze the histopathology of polypoidal choroidal vasculopathy (PCV) and choroidal neovascularization (CNV) developing from PCV, the authors evaluated correlations between pathological findings and the findings of preoperative indocyanine green angiography (IA).Methods Two specimens were obtained during CNV excision associated with PCV. PCV tissue was excised with the CNV. The specimens were examined by light microscopy.Results In one case, IA revealed polypoidal lesions exhibiting hyperfluorescence in both the early and the late phase, and in the affected area, abnormally dilated vessels were identified histologically underneath relatively healthy retinal pigment epithelium (RPE). In the other case, the polypoidal lesions seen on IA showed early hyperfluorescence and late isofluorescence, and dilated vessels were observed under the RPE; perivascular amorphous material was present. The RPE adhered to the side of the choroid, and there was CNV under the neurosensory retina in both cases. The CNV had numerous vascular lumens, was not surrounded by the RPE, and exhibited few fibrous components.Conclusions IA findings vary depending on the condition of the RPE located above the PCV and the extent of amorphous material around the PCV. Jpn J Ophthalmol 2004;48:249–255 © Japanese Ophthalmological Society 2004     

A Macular Hole in a Female Adult with Bilateral Coats Disease

Purpose:To report a case of a macular hole in a female adult with bilateral Coats disease.Methods:The fundus photograph, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed in two eyes, and observed theirs characters.Results:Fundus photograph showed massive yellowish-white exudation in the temporal midperiphery of both eyes, but the degree was slighter in the right eye. There was 1/3 DD macular hole in left eye. FFA revealed general dilatation of capillaries, multiple aneurysms, and tortuous and closure of vessels in superotemporal midperiphery in both eyes, but the degree was slighter in the right eye. There was a one-third DD round transmitted fluorescence according the macula hole. ICGA revealed that hyperfluorescence of aneurysms in superotemporal midperiphery, the images of aneurysms were more clearly than in FFA. There was a 2/3 DD hypoflurescence of macula in the late phase of angiography.Conclusions: FFA and ICGA have respective advantage in revealing vas     

脉络膜转移癌的荧光素和吲哚菁绿血管造影的影像分析

目的：比较脉络膜转移癌的荧光素眼底血管造影(FFA)及吲哚菁绿血管造影(ICGA)的影像特点,为该疾病的准确诊断提供依据。

方法：经临床诊断,有明确原发恶性肿瘤病灶的患者6例8眼,散瞳后行眼底照相,用海德堡眼底血管造影仪行FFA及ICGA同步造影,比较两种影像学检查的异同。

结果：FFA早期显示瘤体为低荧光,中期呈现针尖样或斑点样荧光,晚期表现为斑驳样强荧光,部分病例病灶边缘呈强荧光环带; ICGA显示的病灶表现为低荧光,整个造影过程中荧光强弱无明显变化,仅有1例病例在反转期出现中央及病灶周围的点状强荧光。

结论：FFA和ICGA对于脉络膜转移癌有较为特征性的表现,二者结合有助于脉络膜转移癌的诊断。     

Indocyanine green angiographic findings in fellow eyes of patients with unilateral occult neovascular age-related macular degeneration

Purpose: To determine the role of indocyanine green angiogaphy (ICGA) in the prediction of the development of choroidal neovascularization (CNV). Methods: We reviewed the ICG angiograms of 124 patients with newly diagnosed unilateral occult CNV secondary to age-related macular degeneration (AMD) in whom the fellow eye had only drusen by biomicroscopy and fluorescein angiography. Follow-up data of at least 12 months were obtained in all eyes. Results: 113 fellow eyes had a normal ICG study, while 11 fellow eyes revealed plaque-like late hyperfluorescence. During an average follow-up time of 18.2 months exudative AMD developed in 7 of 11 eyes with late hyperfluorescence on ICGA and in 6 of 113 with a normal ICGA study. Conclusion: ICGA may help to predict which fellow eyes are at higher risk of developing future exudative changes. This revised version was published online in September 2006 with corrections to the Cover Date.     

老年黄斑变性玻璃膜疣的吲哚菁绿血管造影

目的：探讨老年黄斑变性（AMD）玻璃膜疣的吲哚菁绿血管造影（ICGA）特征及其临床意义。方法：对10例16眼早期AMD患者进行眼底荧光血管造影（FFA）及ICGA。结果：⑴FFA早期玻璃膜疣为透见荧光,后期部分呈现着色现象。⑵ICGA早期可见脉络膜充盈迟缓或不规则,后期可见脉络膜渗漏高荧光区、点状强荧光及斑状强荧光团。玻璃膜疠为遮蔽荧光。此外可见涡状静脉异常。结论：AMD早期即有明显的脉络膜循环紊乱及可疑非活动性新生血管生成。对AMD患者进行FFA和ICGA眼底血管对照检查,对了解AMD的发病机理,及早发现潜在的脉络膜新生血管,以尽早给予适当的预防性治疗均有重要意义。     

息肉状脉络膜血管病变并发玻璃体积血的机制研究

息肉状脉络膜血管病变（ｐｏｌｙｐｏｉｄａｌｃｈｏｒｏｉｄａｌｖａｓｃｕｌｏｐａｔｈｙ,ＰＣＶ）曾被称为“特发性息肉状脉络膜血管病变”,是一种多发的反复发作性浆液性视网膜神经上皮和色素上皮脱离伴脉络膜息肉样血管异常。ＰＣＶ被分为两型:渗出型和出血型,其中出血型容易发生玻璃体积血。近年来,随着吲哚青绿血管造影与光学相干断层扫描技术在眼科的普遍应用,国内外对该病的研究逐渐深入。本文结合国内外研究的最新进展,对ＰＣＶ合并玻璃体积血的流行病学、发病机制、诊断以及经玻璃体切除术治疗后眼底、眼底荧光素血管造影及吲哚青绿血管造影的改变进行了综述。