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。     

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。     

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…     

高度近视眼荧光素眼底血管造影与吲哚青绿血管造影分析

目的 探讨高度近视眼荧光素眼底血管造影（fundus fluorescein angiography，FFA）和吲哚青绿血管造影（indocyanine green angiography，ICGA）同步检查的影像学特征及其临床意义。 方法 随机选择屈光状态-6 D以上的高度近视患 者30例57只眼，进行FFA和ICGA同步检查，对比分析其FFA和ICGA检查图像。 结果 57只眼中FFA显示早期背景 荧光减弱25只眼，晚期显示新生血管形成10只眼，漆纹样裂纹形成40只眼；ICGA显示睫状后短动脉8只眼，背景荧光减弱35 只眼，脉络膜新生血管形成8只眼，漆纹样裂纹形成52只眼。 结论 高度近视眼的FFA和ICGA 检查的影像学特征主要表现为背景荧光减弱，漆纹样裂纹及脉络膜新生血管形成。FFA 和ICGA 同步检查能更全面地了解高度近视患者眼底视网膜与脉络膜的病理变化，有助于全面地了解病情和指导进一步治疗。 （中华眼底病杂志，2003，19：87-89）     

原田病的吲哚青绿血管造影特征

目的 探讨原田(Harada)病的吲哚青绿血管造影(indocyanine green angiography,ICGA)特征。 方法 对26例经荧光素眼底血管造影(fundus fluorescien angiography,FFA)确诊的Harada病患者26例52只眼同时进行ICGA检查。 结果 Harada病的主要ICGA表现为：①早期异常暗的背景荧光5例8只眼;②脉络膜灌注不良12例18只眼;③脉络膜血管及涡静脉扩张20例34只眼;④晚期斑片状强荧光8例12只眼;⑤中周及后极部斑点状弱荧光4例5只眼。 结论 Harada病ICGA特征：早期异常暗的背景荧光,脉络膜灌注不良,脉络膜血管及涡静脉扩张,中周及后极部斑片状弱荧光,晚期可见斑片状强荧光。(中华眼底病杂志,2000,16:12-13)     

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。     

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)     

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.     

不明原因黄斑出血的吲哚青绿脉络膜血管造影

目的:探讨眼底荧光血管造影不能确定出血原因的黄斑出血的原发病灶。方法:对18例(20眼)不明原因黄斑出血作了吲哚青绿脉络脉络膜血管造影检查及分析。结果:本文结果表明导致不明原因黄斑出血的原发病灶有三类:脉络膜新生血管形成、视网膜血管异常和黄斑区偶发性出血。其中脉络膜新生血管导致的不明原因黄斑出血占多数(14眼),而由视网膜血管异常(3眼)和黄斑区偶发性出血(3眼)所致的不明原因黄斑出血比率较少。结论:吲哚青绿脉络膜血管造影对揭示不明原因黄斑出血的原发病灶有非常重要的价值。眼科学报 1997;13:62～66。     

护理干预在荧光素眼底血管造影和吲哚青绿眼底血管造影中的应用

目的探讨使用护理干预的方法在荧光素眼底血管造影（FFA）和吲哚青绿眼底血管造影（ICGA）检查中的应用,以减少药物所产生的不良反应。方法将476例FFA检查患者按入院时间分为对照组1与干预组1各238例;将112例ICGA检查患者按入院时间分为对照组2与干预组2各56例;,对照组按常规行FFA和ICGA检查,干预组在此基础上针对造影所致的胃肠道反应、过敏反应和神经系统反应等进行护理干预。结果干预组胃肠道反应、过敏反应和神经系统反应的发生率显著低于对照组（均P〈0.01）。结论护理干预有助于FFA和ICGA检查患者安全、顺利地完成检查,减少并发症的发生。     

共焦激光扫描检眼镜在脉络膜黑色素瘤血管造影中的应用

目的将共焦激光扫描检眼镜(cSLO)应用于脉络膜黑色素瘤中,比较同步情况下的荧光素眼底血管造影(FFA)和吲哚青绿(ICGA)造影的肿瘤内部瘤体血管尤其是微血管的显示率,并对所显示的微血管图像特点加以描述。设计回顾性病例系列。研究对象14例(14眼)脉络膜黑色素瘤患者。方法对14例未经治疗的脉络膜黑色素瘤患者采用cSLO进行同步ICGA和FFA检查,每例患者均行不同深度的共焦系列扫描并对两种造影图像进行对比分析。主要指标脉络膜黑色素瘤内微血管显示率及其特征。结果14例患者中,12例(86％)ICGA肿瘤内部不同深度的共焦系列扫描中可以显示有微血管,而FFA检查仅4例(28％)可见瘤体微血管并且仅仅在早期。1例在FFA及ICGA均可见到粗大瘤体血管。只有1例在FFA及ICGA均未见到肿瘤内血管存在。两种检查方法在发现肿瘤内微血管方面差异有统计学意义(P=0．004)。结论应用共焦激光扫描检眼镜结合ICGA显示肿瘤内部微血管特征性改变较FFA更有优势。     

Scanning laser ophthalmoscopy of choroidal neovascularisation using indocyanine green

Background: Choroidal neovascularisation is an important cause of visual loss in age-related macular degeneration. Visualisation of these choroidal abnormalities with fluorescein angiography may be difficult, particularly if there is haemorrhage, excessive pigment, or excessive fluorescence. We report on our experience with indocyanine green (ICG) angiography in demonstrating choroidal neovascularisation.
Method: Patients with suspected choroidal neovascularisation were assessed with indocyanine green angiography using the Rodenstock Scanning Laser Ophthalmoscope and results recorded on a videotape. Fluorescein angiograms were also obtained in a similar fashion. The angiograms were then compared.
Results: In some instances ICG angiography was able to demonstrate the margins and structure of choroidal neovascular membranes more clearly than fluorescein, particularly in the presence of haemorrphage, excessive fluorescence and blocked fluorescence. However, there were instances where it was difficult to interpret the choroidal abnormalities found. Some illustrative cases are discussed.
Conclusion: We conclude that ICG angiography is a useful adjunct to fluorescein angiography in detection and delineation of choroidal neovascularisation, but that further study is needed.     

Comparative evaluation of oral fluorescein angiography using the confocal scanning laser ophthalmoscope and digital fundus camera with intravenous fluorescein angiography using the digital fundus camera

BACKGROUND: To study the efficacy of oral fluorescein angiography (FA) with confocal scanning laser ophthalmoscope (CSLO). METHODS: Ten patients each of choroidal neovascular membrane, central serous retinopathy, diabetic retinopathy and five normal subjects were evaluated with group 1 - intravenous FA using digital fundus camera (DFC); group 2 - oral FA using DFC; and group 3 - oral FA using CSLO. RESULTS: Third-order branch vessels were identified in 85.7% eyes in group 3 versus 51.4% in group 2 (P = 0.004), image quality was comparable to intravenous FA in 77.1% in group 3 versus 48.5% in group 2 (P = 0.02) and margin delineation was better in 80% eyes in group 3 versus 35% in group 2 (P = 0.01). The foveal avascular zone was clear and intact in 54.2% eyes in group 3 versus 37.1% in group 2 (P = 0.14) and 57.1% in group 1 (P = 0.8). CONCLUSION: Oral FA using CSLO is superior to oral FA using DFC and comparable to intravenous FA using DFC in terms of image quality, branch retinal vessel identification and margin delineation.     

应用共聚焦激光扫描血管造影技术诊断孤立性脉络膜血管瘤

目的评价激光扫描血管造影技术在诊断孤立性脉络膜血管瘤中的应用价值。设计回顾性病例系列。研究对象临床诊断为疑似脉络膜血管瘤35例患者。方法对临床疑似为脉络膜血管瘤患者35例,彩色眼底照相后,行30°及150°视野共聚焦激光扫描血管造影检查。主要指标共聚焦激光扫描血管造影的成像特征。结果荧光素眼底血管造影(FFA)特征为所有35例患者动脉前期或动脉期即显荧光,至动静脉期荧光增强、融合,荧光素渗漏,其间夹杂斑点状弱荧光;静脉早期瘤体呈多湖状,可见血管网形态,晚期荧光素渗漏呈强荧光区。吲哚氰绿血管造影(ICGA)早期可清晰显现瘤体由脉络膜血管团组成,随后染料渗漏,荧光增强,融合呈强荧光灶。150°广角视野共聚焦激光扫描眼底成像提供了瘤体的整体形态。结论激光扫描血管造影技术中FFA和ICGA同步造影及全景造影为孤立性脉络膜血管瘤诊断提供更多的信息。     

Ophthalmic imaging today: an ophthalmic photographer's viewpoint - a review

Ophthalmic imaging has changed dramatically since the 1960s with increasingly complex technologies now available. Arguably, the greatest changes have been the development of the digital camera and the speed, processing power and storage of electronic data. Already, ophthalmic practices in many major institutions overseas have paperless medium storage and electronically generated reporting from all equipment that use a computer interface. It is hard to remember the widespread use of photographic film with its attendant costs, or even to remember the days before optical coherence tomography (OCT). These latest technical improvements in ophthalmic imaging are now standard in large Australian institutions and becoming more widespread in smaller private practices. The technicians that operate and maintain this ever-increasing plethora of gadgetry have seen their work practices change from the darkroom to the complexities of data-based imaging and storage. It is a fitting time to examine the contemporary state of ophthalmic imaging and what lies on the horizon as we move towards 2020.     

脉络膜转移癌荧光素及吲哚青绿血管造影的影像分析

目的了解脉络膜转移癌共焦激光扫描检眼镜同步荧光素眼底血管造影（FFA）、吲哚青绿血管造影（ICGA）影像特点,为该疾病的准确诊断提供依据。设计回顾性病例系列。研究对象明确原发灶的脉络膜转移癌患者12例（17眼）。方法经临床诊断、有明确原发恶性肿瘤病灶的患者12例（17眼）,散大瞳孔后拍摄彩色眼底像,用海德堡共焦激光扫描检眼镜进行FFA及ICGA同步造影,观察两种影像学检查的异同。主要指标FFA及ICGA各期瘤体荧光表现及差异。结果FFA早期16眼瘤体呈低荧光。ICGA早期17眼瘤体均为低荧光,且低荧光范围略大于FFA;11眼在瘤体边缘见异常脉络膜血管。FFA静脉期显示瘤体表面视网膜血管迂曲、毛细血管扩张及微血管瘤;中晚期渗漏明显,肿瘤边界模糊,色素斑块及出血表现为荧光遮蔽。ICGA中晚期,13眼瘤体边缘见斑驳淡荧光,4眼淡荧光位于瘤体中央,晚期瘤体轮廓较FFA清晰。对于1眼瘤体扁平、面积较小的病灶,ICGA可清晰显示,而FFA表现不典型。结论ICGA对确定肿瘤特别是小而扁平的瘤体的轮廓及脉络膜血管异常有优越性,FFA可显示肿瘤导致的视网膜血管及色素上皮改变。二者结合,有助于脉络膜转移癌的诊断。     

Videofunduscopy and videoangiography using the scanning laser ophthalmoscope in Vogt-Koyanagi-Harada syndrome

AIM—To observe pathophysiological changes in patients with Vogt-Koyanagi-Harada (VKH) syndrome using the scanning laser ophthalmoscope (SLO) to perform videofunduscopy, and indocyanine green (ICG) and fluorescein videoangiography.
METHODS—18 patients diagnosed with VKH syndrome were studied. 15 patients were examined in both acute and convalescent phases, and three patients were examined in the convalescent phase only. Retrospective review of charts was performed to obtain data on visual acuities, clinical findings, and results of cerebrospinal fluid cytology and histocompatibility leucocyte antigen D locus testing.
RESULTS—Videofunduscopy revealed abnormalities in the central macula at the level of the retinal pigment epithelium or choroid in 40% of patients in the acute phase and 83% of patients in the convalescent phase. ICG videoangiography showed irregular hypofluorescence (80%), slow or patchy filling (67%), indistinct or fewer choroidal vessels (73%), filling defects (73%), and focal leakage (33%) in patients in the acute phase. These changes improved with systemic corticosteroid treatment, although at least one ICG videoangiographic abnormality persisted into the convalescent phase in 83% of patients in the absence of clinical inflammation. In contrast, fluorescein videoangiography revealed fewer and decreased severity of abnormalities, with greater resolution in the convalescent phase when compared with ICG videoangiography.
CONCLUSIONS—SLO videofunduscopy and videoangiography revealed numerous abnormalities in patients with VKH syndrome, many of which persisted well after clinical recovery, suggesting the development of permanent morphological changes in the fundus. ICG videoangiography was more sensitive than fluorescein videoangiography in delineating abnormalities in layers deep to the sensory retina.

Keywords: fluorescein; fundus angiography; indocyanine green; Vogt-Koyanagi-Harada syndrome     

Reproducibility of fundus autofluorescence measurements obtained using a confocal scanning laser ophthalmoscope

AIM: To evaluate the reproducibility of the background fundus autofluorescence measurements obtained using a confocal scanning laser ophthalmoscope. METHODS: 10 normal volunteers and 10 patients with retinal disease were included in the study. One eye per subject was chosen randomly. Five images of the same eye of each individual were obtained, after pupillary dilatation, by two investigators using a confocal scanning laser ophthalmoscope. Background fundus autofluorescence was measured at 7 degrees temporal to the fovea in normal volunteers and between 7 and 15 degrees temporal to the fovea in patients. Within session reproducibility of the measurements obtained by each investigator and interobserver reproducibility were evaluated. RESULTS: For investigator 1 the median values of fundus autofluorescence obtained were 31.9 units for normal volunteers and 27.3 units for patients. The median largest differences in readings in normal volunteers was 5.7 units (range 1.4-13.5 units) and in patients 4.2 units (1.5-15.1 units). For investigator 2 the median values of fundus autofluorescence obtained were 28.9 units for normal volunteers and 27.4 units for patients. The median largest difference in readings in normal volunteers was 3.6 units (2.7-11.7 units), and in patients 4.1 units (1.5-9.3 units). The median interobserver difference in readings in normal volunteers was 3.3 units and for patients 6.6 units. The median greatest interobserver difference in measurements obtained for normal volunteers was 8.8 units (8.4-23.0 units) and for patients 11.1 units (7.1-40.8 units). CONCLUSION: Within session reproducibility of the measurements of background fundus autofluorescence was satisfactory. Although interobserver reproducibility was moderate, the variability of the measurements of fundus autofluorescence between observers appears to be small when compared with variation in fundus autofluorescence with age and disease.