孤立性脉络膜血管瘤的共焦激光扫描吲哚青绿血管造影

目的探讨孤立性脉络膜血管瘤在共焦激光扫描（confocal scanning laser ophthalmoscopy,cSLO）吲哚青绿血管造影（indocyanine green angiography,ICGA）中的临床表现特征。方法采用眼底彩色照相,共焦激光扫描（cSLO）同步完成眼底荧光血管造影（fundus fluorescein angiogra-phy,FFA和ICGA）,对6例6眼孤立性脉络膜血管瘤患者进行检查。结果接受ICGA检查的6眼中,5眼瘤体周围有脉络膜毛细血管萎缩区;5眼瘤体晚期有明显排空。3眼可见瘤体下方有带状RPE萎缩;1眼FFA合并黄斑囊样水肿。结论cSLO的ICGA检查,对孤立性脉络膜血管瘤的诊断与鉴别诊断有重要的临床价值。     

眼挫伤后脉络膜病变FFA及ICGA的对比观察

目的 应用荧光素和吲哚青绿眼底血管造影，了解眼挫伤后脉络膜血管的病变。方法 应用德国Heidelberg共焦激光扫描眼底血管造影技术对眼挫伤患者16例（17眼）进行荧光素和吲哚青绿血管造影检查，观察脉络膜血管的异常变化。结果 17眼中，眼底荧光素血管造影显示视网膜血管充盈时间和血管形态大致正常，显示高网膜渗漏5眼。眼底吲哚青绿血管造影显示局限性脉络膜充盈延迟16眼、血管扩张5眼、荧光遮蔽2眼及吲哚青绿渗漏8眼。结论 由于脉络膜血管主要供应视膜外层，因此外伤性视网膜脉络膜病变对视功能影响很大，吲哚青绿血管造影提供了对各种程度脉络膜血管损害的分析依据。     

浅谈吲哚青绿血管造影的临床释义

吲哚青绿血管造影 (indocyanine green angiography,ICGA)是以近红外光或红外激光为激发光 ,吲哚青绿 (indocya-nine green,ICG)为染料 ,通过实时图像采集、处理系统记录眼底尤其是脉络膜血液循环动态图像的一种技术。近几年来 ,ICGA已在眼底病的临床诊断、治疗、疗效观察及发病机制研究等方面发挥了越来越大的作用。但由于所采用的激发光、染料的特性及脉络膜血流动力学的复杂性 ,以及 ICGA所见的异常荧光不仅与病变本身的结构 ,而且与所用的图像采集系统有关等原因 ,使得 ICGA的荧光图像比荧光素眼底血管造影 (fundusfluorescein …     

青光眼视盘的吲哚青绿眼底血管造影

吲哚青绿眼底血管造影(ICGA)能较好而直观地显示脉络膜血液循环,近年来,这项技术已开始应用于青光眼视盘血供的研究,以帮助阐明青光眼视神经病变的发生机制。本文对青光眼视盘的ICGA造影过程、表现、意义及临床应用前景进行综述。     

青光眼视盘的吲哚青绿眼底血管造影

吲哚青绿眼底血管造影(ICGA)能较好而直观地显示脉络膜血液循环，近年来，这项技术已开始应用于青光眼视盘血供的研究，以帮助阐明青光眼视神经病变的发生机制。本对青光眼视盘的ICGA造影过程、表现、意义及临床应用前景进行综述。     

中心性渗出性脉络膜视网膜病变的吲哚青绿造影特征

目的:分析中心性渗出性脉络膜视网膜病变(central exudative chorioretinopathy,CEC)吲哚青绿血管造影(indocyaninegreen angiography,ICGA)特点。方法:应用海德堡造影系统HRA2对24例24眼CEC患者进行荧光素、吲哚青绿眼底血管造影,并对ICGA与眼底荧光造影(fundus fluorescein angiography,FFA)结果进行对比分析。结果:CEC患者24眼FFA均证实为典型性脉络膜新生血管(choroidal neovascularization,CNV)。ICGA早期,24例CEC可见边界清晰的网状CNV。5例见CNV周围局限性脉络膜血管扩张。ICGA晚期可见CNV处染料渗漏或染色。20眼ICGA早期可见宽窄不一的暗环包绕CNV,4眼未见暗环。ICGA晚期,24眼CNV周围均可见暗环。1例患者光动力(photodynamic therapy,PDT)治疗后2mo,因视力继续下降复查ICGA,可见视网膜脉络膜血管吻合(retinal-choroidal anastomosis,RCA)。结论:由HRA2进行的ICGA对CEC的CNV的结构、边界、局部脉络膜静脉的改变、RCA的显示优于FFA。     

中心性渗出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：观察中心性渗出性脉络膜视网膜病变（简称中渗）的吲哚青绿血管造影（indocyanine green angiography,ICGA)和荧光素眼底血管造影（fudus fluorescein angiography,FFA) 的特征。方法：对临床诊断中渗的16例（19眼）采用ICGA和FFA检查,对两种造影图像进行对比分析。结果：被检查19眼中,15眼FFA动脉期脉络新生血管和ICGA早期黄斑区荧光斑相应,而ICGA晚期荧光亮度加强,范围扩大,比FFA晚期更清晰。另有4眼FFA动脉黄斑部未见脉络膜新生血管轮廓,而在ICGA早期黄斑病变区见到荧光斑,晚期荧光斑加强,并向四周渗渗,比FFA范围明显扩大。结论：ICGA因红外光对色素上皮及黄斑叶黄素穿透性好而弥补FFA不足,但不能代替FFA,二才相互补充,可提高中渗脉络膜新生血管的诊断率。     

多灶性脉络膜炎眼底血管造影的改变

目的 探讨多灶性脉络膜炎(multifocal choroiditis)患者的临床表现及吲哚青绿血管造影(ICGA)和荧光素眼底血管造影(FFA)的特点。 方法 收集多灶性脉络膜炎患者8例10只眼，分别对其临床特征和眼底血管造影图像进行分析。 结果 8例患者均表现为眼底后极部和周边部的多灶性脉 络膜病变；ICGA显示病灶区呈弱荧光，提示为脉络膜灌注不良；非活动性病灶表现为荧光染色和透见荧光，萎缩处可见脉络膜大血管。FFA显示病灶区呈弱荧光，活动性病灶晚期有渗漏，非活动性病灶呈透见荧光。 结论 原发于脉络膜的多灶性脉络膜炎的临床表现随病程长短、病变部位的不同和病灶多少而各异，ICGA和FFA可清晰地显示病变发展的过程，并可用于指导临床治疗。 （中华眼底病杂志，2004，20：87-89）     

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     

吲哚青绿血管造影中陈旧性眼底出血的自发荧光分析

目的：观察老年性黄斑变性（Age—relatedmaculardegeneration，AMD）和息肉状脉络膜视网膜病变（Polypoidalchoroidalvasculopathy，PCV）患者眼底陈旧性出血在吲哚青绿血管造影（Indocyaninegreenangiography，ICGA）中的自发荧光表现。方法：对伴有眼底陈旧性出血的AMD和PCV患者共36例（36只眼）行ICGA检查。受试者在进行ICGA检查前．均经过详细的眼底镜检查、眼底彩色照相及荧光素眼底血管造影（Fundusfluoresceinangiography，FFA）检查。结果：眼底陈旧性出血灶ICGA均表现出相应的自发荧光。陈旧性出血灶呈浅灰黄色，其自发荧光的形态大小与眼底彩色图像所示的陈旧性出血灶相一致，边界清晰；造影后期陈旧性出血灶的自发荧光强度最强，与AMD的斑状及焦点状脉络膜新生血管（Choroidal neovasculari zation．CNV）及PCV的息肉状脉络膜血管扩张灶的荧光表现不同。陈旧性眼底出血的自发荧光多与CNV或息肉状病灶重叠或位于其边缘（27只眼，75％）。结论：ICGA中陈旧性眼底出血所致的自发荧光易与CNV及息肉状病灶性强荧光相混淆，将眼底彩色图像与ICGA图像对比分析及掌握其与CNV及息肉状血管扩张灶的不同荧光特性有助于鉴别诊断。     

Stargardt病的FFA和ICGA同步造影释义

目的：了解Stargardt病在同步进行的眼底荧光血管造影（fundus fluorescein angiography,FFA)和吲哚青绿血管造影(indocyanine green angiography,ICGA)过程中,不同时期的荧光表现。方法：使用海德堡共焦激光眼底扫描系统（Heidelberg Retina Angiography,HRA),对7例14眼典型的Stargardt病患者进行FFA和ICGA同步造影检查,对所摄取的同步图像进行同期对比分析。结果：14只眼的FFA检查均表现出明显的脉络膜湮没征（choroidal silence sign or dark choroid),ICGA则能显现脉络膜血管,但有10只眼的脉络膜血管影像比正常的暗。黄斑部病变在FFA检查中,14只眼均表现为典型的横椭圆形强烈的透见荧光,而在ICGA检查中,早期14只上均表现出比周期更强的脉络膜血管荧光,晚期(＞20分钟）有8只眼发现围绕黄斑病灶有一环形的弱荧光晕,8只眼除黄斑病灶外还伴有黄色斑点,在FFA检查中,黄色斑点大部分表现为高荧光斑,而在ICGA检查中则在大部分表现为低荧光斑,偶而有散在的高荧光点。结论：FFA和ICGA同步造影可以帮助我们了解同一病变部位,在同一时刻,不同造影的不同荧光表现,其联合应用可以加深对Stargardt病病理的认识和理解。     

伏格特小柳原田综合征的吲哚青绿眼底血管造影观察

目的 探讨利用吲哚青绿血管造影(indocyanine green angiography,ICGA)检查作为伏格特小柳原田(Vogt-Koyanagi-Harada,VKH)综合征临床观察指标的意义。 方法 对26例VKH患者荧光素眼底血管造影(fundus fluorescein angiography,FFA)和ICGA检查资料进行分析。 结果 FFA表现为色素上皮水平多数针尖状渗漏,快速形成多湖状荧光积存。治疗后上述改变很快消失。葡萄膜炎期ICGA表现：①66.7%的患眼为多数灶状弱荧光区域和脉络膜大、中血管荧光影像减少;②70.8%的患眼脉络膜血管扩张;③79.2%的患眼为造影后期显示灶状强荧光区。在病变恢复期,与FFA检查比较,ICGA的异常发现恢复缓慢。 结论 ICGA 可较好提供VKH的脉络膜循环损害的信息,并在评价疗效上有意义。(中华眼底病杂志,2000,16:9-11)     

Vogt-小柳-原田综合征葡萄膜炎期荧光素钠及吲哚菁绿同步眼底血管造影特征分析

目的探讨Vogt-小柳-原田综合征(Vogt-Koyanagi-Harada disease,VKH)葡萄膜炎期荧光素钠及吲哚菁绿同步眼底血管造影的影像学特征及其临床意义,为诊断及病程监测提供依据。方法回顾性分析11例22眼VKH葡萄膜炎期患者应用海德堡HRA2共焦激光扫描眼底血管造影系统进行的荧光素钠眼底血管造影(fundus fluorescein angiography,FFA)和吲哚菁绿血管造影(indocyanine green angiography,ICGA)同步检查资料,比较2种检查的影像学特征。结果 11例22眼中,FFA检查8眼(36.36%)后极部多处脉络膜充盈迟缓;9眼(40.91%)视盘渗漏水肿;22眼(100.00%)后极部视网膜色素上皮密集针尖状高荧光渗漏,18眼(81.82%)后极部神经上皮脱离部位FFA晚期形成多囊样或多湖状荧光积存;13眼(59.09%)静脉期散在、均匀脉络膜炎性病灶,呈斑点状低荧光。ICGA检查15眼(68.18%)脉络膜充盈迟缓;14眼(63.64%)脉络膜血管扩张;16眼(72.73%)播散状分布、斑点状脉络膜炎性低荧光病灶;18眼(81.82%)后极部神经上皮脱离区大多呈现持续低荧光,晚期部分囊样病灶呈中强荧光;9眼(40.91%)视盘水肿晚期显示视盘及盘周低荧光。FFA和ICGA同步检查结果:FFA检查100.00%患眼静脉期视盘周及后极部密集点状高荧光渗漏,而在ICGA上无此征象;FFA检查视盘表面毛细血管扩张比ICGA显示更明显;ICGA检查脉络膜充盈迟缓15眼(68.18%)及斑点状炎性病灶16眼(72.73%),均高于FFA检查结果的8眼(36.36%)和13眼(59.09%),而且ICGA早期脉络膜血管扩张显示更清晰;后极部神经上皮脱离病灶在FFA静脉期表现为低荧光,晚期形成荧光积存,而病变区域ICGA检查相应部位多为持续低荧光。结论 VKH葡萄膜炎期FFA清晰显示视网膜色素上皮损伤特征以及炎症累及视盘、视网膜的程度和范围;ICGA能够清晰显示脉络膜循环改变及脉络膜炎症的活动性和范围。FFA和ICGA同步检查对VKH诊断及发病机制有重要的指导意义。     

原田病药物治疗后吲哚青绿眼底血管造影观察

目的 探讨利用吲哚青绿血管造影检查作为原田(Harada)病临床观察指标的意义.方法 对经药物治疗后19例(38只眼)原田病患者同时行荧光素眼底血管造影(fundus fluorescein angiography,FFA)及吲哚青绿血管造影(indocyanine green angiography,ICGA)检查资料进行分析.结果 FFA检查发现有4例(8只眼)视盘轻度染色,视网膜未发现异常改变;ICGA早期及中期无异常表现,但后期8只眼(包括FFA中视盘染色的4只眼)在中周及后极部出现了点状或斑片状弱荧光;3例6只眼FFA及眼底正常,在ICGA后期后极部出现了斑点状弱荧光;24只眼脉络膜大、中血管影像减少,其中12只眼dalen-fuchs结节着色.结论 ICGA可较好提供原田病的脉络膜循环损害的信息,并在评价疗效上有意义.

Abstract：

Objective To investigate the clinical value of indocyanine green angiography(ICGA)in patients with Harada disease.Methods Fundus fluorescein angiography(FFA)and indocyanine green angiography(ICGA)were used for comparative analyses in 26 cases(52 eyes)of Harada disease after treatment.Results Mild dyeing in disk was found only in 4 cases(8 eyes),and the others were not found any abnormal in FFA.There were no any abnormal found in early period and middle period of ICGA,but of 8 eyes(include 4 eyes of dyeing in disk in FFA)multifocal lower fluorescence were found in the mid-periphery and posterior pole of the fundus in the late phase.Of 3 cases(6 eyes)were normal in FFA,however multifocal lower fluorescence were found in the posterior pole of the fundus in the late phase of ICGA.Of 24 eyes were found decreased fluorescence in large and middle choroidal vessel,and 12 eyes of Dalen-Fuchs were colored.Conclusions ICGA may assist in providing valuable information on choroidal circulation of Harada disease and be useful in evaluating the curative effects.     

多发性后极部色素上皮病变的吲哚青绿和荧光素眼底血管造影

目的 研究多发性后极部色素上皮病变(multifocal posterior pigment epitheliopathy,MPPE)的视网膜和脉络膜循环特点,探讨该病的发病机制及其与中心性浆液性脉络膜视网膜病变(central serouschorioretinopathy,CSC)之间的关系。 方法 对6例MPPE患者的7只眼吲哚青绿血管造影(indocyanine green angiography,ICGA)和荧光素眼底血管造影(fundus fluorescein angiography,FFA)检查结果进行对比分析。 结果 5例5只眼FFA检查为活动期,其中4只眼在ICGA造影早期有脉络膜充盈延迟,占80%。FFA显示有渗漏处,ICGA均有相应的渗漏灶。在渗漏灶的周围及后极部尚有弥漫性相对强荧光。病变恢复期,FFA已无明显渗漏,ICGA仍显示脉络膜荧光渗漏。 结论 MPPE与CSC有着相同的ICGA改变,但前者病变范围更加广泛。MPPE为CSC的较严重型,为原发于脉络膜病变的疾病。(中华眼底病杂志,2000,16：6-8)     

Choroidal folds in Vogt-Koyanagi-Harada disease

PURPOSE: To analyze choroidal folds in Vogt-Koyanagi-Harada (VKH) disease by fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT). DESIGN: Retrospective, consecutive case series. METHODS: Records of 95 patients diagnosed with VKH disease from October 2001 to July 2006 were reviewed. All patients underwent FA, 17 patients underwent ICGA, and 20 underwent OCT. RESULTS: Of the 95 patients, 11 (12.0%) had choroidal folds and showed 10 to 15 hypofluorescent bands radiating from the optic disk that were similar to the large retinal vessels in shape and number on FA. On ICGA, the choroidal folds showed hyperfluorescence at the late stage. OCT showed clear folds but the number of folds was larger than on FA and ICGA. CONCLUSIONS: Choroidal folds are not uncommon in VKH disease. FA, ICGA, and OCT can help to identify their pathogenesis.     

Inflammation of the posterior uvea: findings on fundus fluorescein and indocyanine green angiography

PURPOSE: To investigate the additional benefit of indocyanine green angiography (ICGA) over fundus fluorescein angiography (FA) in patients with posterior uveal inflammation. METHODS: The features of 19 patients with different forms of posterior uveitis (Vogt-Koyanagi-Harada disease [n = 5], serpiginous choroiditis [n = 5], multifocal choroiditis [n = 5], and sarcoidosis [n = 4]) were analyzed. RESULTS: On ICGA, inflammatory lesions were hypofluorescent in all phases, and early choroidal vessel dilation and leakage was noted near the lesions. CONCLUSIONS: The combined use of FA and ICGA helps gauge the severity of inflammation in the choroid and the retina during active inflammation. In quiescent stages, however, ICGA does not give any additional information.     

Fundus fluorescein and indocyanine green angiographic study of Behcet's disease and Vogt-Koyanagi-Harada syndrome

OBJECTIVE: To study the choroidal and retinal changes in Behcet's disease and Vogt-Koyanagi-Harada syndrome (VKHS) using indocyanine green angiography (ICGA) and fundus fluorescein angiography (FFA). METHODS: Seventeen cases (27 eyes) of Behcet's disease and 18 cases (36 eyes) of VKHS were examined with FFA and ICGA. All of the patients showed an active intraocular inflammation when examined. RESULTS: FFA showed leakage from retinal vessels in patients with Behcet's disease. ICGA revealed choroidal abnormalities including dilatation and hyperpermeability of choroidal vessels in 11 eyes (40.7%). In VKHS, FFA revealed the hyperfluorescence and serous pigment epithelium detachments. Dilatation and hyperpermeability of choroidal vessels revealed by ICGA were found in 36 eyes (100%), multihypofluorescent dark dots in 32 eyes (88.9%), and choroidal filling defects in 28 eyes (77.8%). CONCLUSIONS: Although retinal vascular lesions are predominant in Behcet's disease, choroidal abnormalities evidenced by dilatation of choroidal vessels are also present in some patients. Hyperfluorescence and hypofluorescence revealed are the main findings in the patients with VKHS. A combination of FFA and ICGA is recommended for the examination of Behcet's disease and VKHS.     

Indocyanine green angiography in birdshot chorioretinopathy.

OBJECTIVE: Birdshot chorioretinopathy (BC) is an ocular inflammatory disease involving both the retina and the choroid. The study goal was to evaluate indocyanine green angiographic features in BC to assess choroidal involvement. DESIGN: Retrospective, observational case series. PARTICIPANTS: Fifty-two patients with BC documented with at least 1 concomitant fluorescein and indocyanine green angiogram. INTERVENTION: Indocyanine green angiography (ICGA) was performed according to a standard protocol used for inflammatory disorders. MAIN OUTCOME MEASURE: Indocyanine green angiographic signs were correlated with fundus photographs, fluorescein angiography, degree of inflammatory activity, and stage of disease. RESULTS: In active disease, three main features were observed. The principal finding, found in 100% of patients, was the presence of hypofluorescent dark dots during the intermediate phase of angiography; their evolutionary pattern was twofold, becoming either isofluorescent or remaining hypofluorescent at the late phase of angiography. The other two signs were fuzzy, indistinct choroidal vessels and late-diffuse choroidal hyperfluorescence. In chronic longlasting disease, the characteristic finding was the presence of hypofluorescent dark dots that persisted in the late phase of disease and is theorized to correspond either to chorioretinal atrophy (irregular geographic pattern) or to persistent choroidal granulomas (round oval form). CONCLUSIONS: Consistent ICGA findings in 52 patients allowed the authors to establish a fairly precise ICGA semiology for BC. This procedure enabled the authors to assess choroidal involvement, and, in selected cases, it also was found to be of diagnostic help and useful to monitor therapeutic intervention.