Indocyanine green angiography of central serous chorioretinopathy

Indocyanine green angiograms of central serous chorioretinopathy in 30 eyes were evaluated in order to demonstrate the pathologic features of the retinal pigment epithelium. In 5 of the cases, the dye leakage or the pigment epithelial degeneration was seen to be associated with areas of choroidal circulatory insufficiency. This implies that local choroidal ischemia is one of the causes of the pigment epithelial disturbance.     

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。     

Indocyanine green angiography in the juvenile haemorrhagic choroidopathy

Juvenile haemorrhagic choroidopathy (JHC) is an idiopathic syndrome marked by macular choroidal neovascularization (CNV) in patients under the age of 50. We used fluorescein angiography (FA) and indocyanine green angiography (ICGA) to examine 17 patients with macular CNV and JHC. CNV was always unilateral. On ICGA examination the CNV were weakly fluorescent in 59% of cases, hyperfluorescent in the remaining 41%.ICGA showed up the following alterations: a) areas with diffuse choroidal hyperfluorescence at the posterior pole or in the peripapillary region in 11 affected eyes (65%), in the fellow eye too in 5 patients; b) areas of choroidal hypofluorescence at the posterior pole but also outside the vascular arcades in 2 affected eyes (12%).In conclusion, ICGA does not appear indispensable for detecting CNV in JHC but this method does show up diffuse choroidal alterations not detectable with FA. The pathogenetic implications of the ICGA findings are discussed.     

原发性闭角型青光眼复合式小梁切除术后眼前节结构的改变

目的探讨原发性闭角型青光眼行复合式小梁切除术后眼前节结构的改变。方法选择原发性闭角型青光眼病例30例（30只眼）,正常人对照组30例（30只眼）,利用超声生物显微镜（UBM）检测所有眼的眼前节,青光眼患者在术前1天和术后1个月、6个月、2年进行检查。结果青光眼患者术前、术后各参数分别与对照组比较,差异均有统计学意义,术后较术前房角开放程度增加,前房深度其他参数无改变。结论原发性闭角型青光眼行复合式小梁切除术可以部分改变眼前节形态。     

Indocyanine green angiography in Bietti's crystalline retinopathy

BACKGROUND: To our knowledge, the indocyanine green (ICG) angiographic features of Bietti's crystalline retinopathy have been described in a single case only. We report the ICG angiographic findings in four patients with Bietti's crystalline retinopathy and compare them with the fluorescein angiographic findings. METHODS: Review of the records of four patients with Bietti's crystalline retinopathy, three of whom were from a single consanguineous family. Fluorescein and ICG angiography were performed with the Heidelberg scanning laser ophthalmoscope. RESULTS: The ICG angiographic findings varied according to the stage of the disease. In the early stages no retinal pigment epithelium (RPE) alterations or choriocapillaris loss were noted. In advanced cases there was extensive chorioretinal atrophy. Most notably, intraretinal crystals did not exhibit fluorescence/cyanescence and had no masking effect on fluorescein or ICG angiography. In all cases angiography showed hypofluorescent/hypocyanescent dots, most likely corresponding to RPE alterations adjacent to atrophic areas. INTERPRETATION: ICG angiography does not give additional information in Bietti's crystalline retinopathy and probably is not superior to fluorescein angiography. However, it delineates the atrophic areas slightly better than does fluorescein angiography.     

Indocyanine green angiography pattern of congenital grouped albinotic retinal pigment epithelial spots

Congenital grouped albinotic retinal pigment epithelial spots (CGARPES) is a rare retinal pigment epithelium disease with multiple, white spots, generally involving the peripheral retina, with variable angiographic pattern. A 46-year-old male affected by CGARPES underwent fluorescein angiography and indocyanine green videoangiography. Fluorescein angiography demonstrated an early hyperfluorescence of the spots. A peculiar pattern was revealed by indocyanine green videoangiography. Indeed, during the early phases the spots were either not detectable on the choroidal background, or presented slightly hypofluorescent, whereas during the intermediate and the late phases some spots became progressively hyperfluorecent. The angiographic behavior on indocyanine green may be explained considering a gradual staining of the lesions, with a progressive binding between the indocyanine green molecule and the abnormal retinal pigment epithelium material.     

Indocyanine green angiography in posterior uveitis

Literature review for indocyanine green angiography and evaluate the role of indocyanine green angiogram (ICGA) in patients with posterior uveitis seen at a tertiary referral eye care centre. Detailed review of the literature on ICGA was performed. Retrospective review of medical records of patients with posterior uveitis and dual fundus and ICGA was done after institutional board approval. Eighteen patients (26 eyes) had serpiginous choroiditis out of which 12 patients had active choroiditis and six patients had healed choroiditis, six patients (12 eyes) had ampiginous choroiditis, six patients (12 eyes) had acute multifocal posterior placoid pigment epitheliopathy, eight patients (10 eyes) had multifocal choroiditis, four patients (eight eyes) had presumed ocular histoplasmosis syndrome, four patients (eight eyes) had presumed tuberculous choroiditis, two patients (four eyes) had multiple evanescent white dot syndrome and two patients (four eyes) had Vogt Koyanagi Harada (VKH) syndrome. The most characteristic feature noted on ICGA was the presence of different patterns of hypofluorescent dark spots, which were present at different stages of the angiogram. ICGA provides the clinician with a powerful adjunctive tool in choroidal inflammatory disorders. It is not meant to replace already proven modalities such as the fluorescein angiography, but it can provide additional information that is useful in establishing a more definitive diagnosis in inflammatory chorioretinal diseases associated with multiple spots. It still needs to be determined if ICGA can prove to be a follow up parameter to evaluate disease progression.     

吲哚青绿在眼科的应用进展

吲哚青绿是一种较安全的吲哚染料，已运用于视网膜和脉络膜造影，现又运用于眼前段造影和区分某些透明组织，本文就吲哚青绿在眼科的应用进展作一综述。     

Indocyanine green angiography in central serous chorioretinopathy

Purpose. To analyse images obtained by indocyanine green angiography in central serous chorioretinopathy (CSC). Methods. Ninety patients affected with CSC were examined using indocyanine green angiography. Results. CSC was detected in 127 of the 180 eyes examined. Leakage points were detected in 99 eyes with fluorescein angiography; in 85 of these eyes, they corresponded o hyperfluorescence with indocyanine green angiography, while a hyperfluorescence of the neuroepithelial detachment was seen in 21 eyes. Areas of choriodal hyperpermeability were seen in all 127 eyes with CSC and in 9 fellow eyes. With ICG angiography, the appearance of pigment epithelial detachments was similar to that previously described (early hyperfluorescence and later hypofluorescence), and was seen in 47 eyes. In 103 eyes, hypofluorescence lesions of various sizes, were detected which became more marked in the later stages. These lesions corresponded to retinal pigment epithelium lesions in fluorescein angiography, mainly hyperfluorescence caused by window defect. We were also able to observe RPE atrophic tracts in 31 eyes. These tracts appeared hyperfluorescent in 11 eyes where a minimal amount of RPE atrophy was present and hypofluorescent in 20 eyes in which the tract had marked RPE atrophy. Conclusion. The results obtained confirm the finding of choriodal hyperpermeability and subretinal diffusion of ICG, which indicate involvement of the choroid in CSC. The observation of progressively hypofluorescent lesions corresponding to retinal pigment epithelium alterations suggests that there may be as yet unknown interactions of pigment epithelium and ICG. This revised version was published online in September 2006 with corrections to the Cover Date.     

脉络膜炎的吲哚青绿血管造影分析

目的 探讨脉络膜炎在吲哚青绿血管造影(indocyanine green angiography,ICGA)下的表现特征。 方法 对13例(16眼)脉络膜炎患者均作了ICGA和眼底荧光血管造影(funds fluorescein angiography,FFA)检查。 结果 ICGA可显示临床和FFA所发现不了的脉络膜炎性损害灶，其表现为：①脉络膜血管扩张，扩张的血管呈节段样外 观、边缘粗糙；②脉络膜血管通透性增高所致的斑片状强荧光；③脉络膜充盈缺损；④脉络膜炎性水肿所致的异常暗背景荧光；⑤涡静脉扩张。 结论 ICGA不仅能较好的评价脉络膜炎的血液循环受损程度,而且能较全面地观察到脉络膜炎所致的损害病灶。(中华眼底病杂志,1998,14:92-94)     

脉络膜黑色素瘤的吲哚青绿和荧光素眼底血管造影

目的 观察脉络膜黑色素瘤的吲哚青绿血管造影(indocyanine green angiography,ICCA)和荧光素眼底血管造影(fundus fluorescein angiography,FFA)的特征. 方法 16例病人采用ICGA和FFA检查,对两种造影图像进行对比分析. 结果 ICGA检查81.2%的肿物不显荧光或晚期呈弱荧光,62.54%肿物可见有诊断特征的瘤体血管,FFA检查仅12.5％肿物可见瘤体血管,肿物在FFA晚期呈强荧光不能确诊时,ICGA可见瘤体血管以助诊断。 结论 脉络膜黑色素瘤ICGA图像特征有助于诊断.(中华眼底病杂志,2000,16：3-5)     

Indocyanine green angiography in the presence of subretinal or intraretinal haemorrhages: clinical and experimental investigations

Purpose: The absorption and emission characteristics of indocyanine green are associated with better penetration through ocular pigments, including melanin and blood, in comparison with fluorescein. Therefore, it has been assumed that indocyanine green angiography (ICG‐A) allows better delineation of fluorescent structures including choroidal neovascularization in the presence of haemorrhages. The degree and frequency of blockage by haemorrhages during ICG‐A and fluorescein angiography (Fl‐A) were compared and absorption characteristics by blood were experimentally determined. Methods: Simultaneous confocal scanning laser ophthalmo­scopy was performed in patients with intraretinal or sub­retinal haemorrhages associated with various retinal diseases including neovascular age‐related macular degeneration. Areas of blocked choroidal fluorescence were compared in Fl‐A and ICG‐A using a standardized classification system by two independent readers. Experimental absorption measurements were performed using blood‐filled quartz cuvettes and laser light with 488 and 790 nm, respectively. Results: Sixty eyes of 59 patients were analysed. Twelve eyes (20%) showed blockage in Fl‐A only corresponding with funduscopically visible blood. In 35 eyes (58%) the extent of absorption was greater in Fl‐A compared with ICG‐A. An identical area of blockage in both Fl‐A and ICG‐A was noted in 13 eyes (22%). The coefficient of absorption was 18.4 mm^‐1 for Fl‐A (488 nm) and 5.4 mm^‐1 for ICG‐A (790 nm). Conclusions: In contrast to previous assumptions, the findings indicate that clinically intraretinal or subretinal haemorrhages are frequently associated with blockage not only in Fl‐A but also in ICG‐A. This is in accordance with the experimentally determined coefficient of absorption. Apparently, haemorrhages occurring in association with retinal and choroidal diseases commonly have a thickness sufficient enough to induce relevant absorption during ICG‐A, and thus impair delineation of fluorescent structures in planes posterior to the haemorrhage. Therefore, the diagnostic value of ICG‐A in presence of subretinal or intra­retinal bleedings is limited.     

前部缺血性视神经病变的吲哚青绿和 荧光素眼底血管造影

目的观察前部缺血性视神经病变( anterior isc hemic optic neuropathy , AION)的吲哚青绿和荧光素眼底血管造影(indocyanine green angiography and fundus fluorescein angiography ,ICGA &; FFA)特征,探讨AION的病因 和发病机制,以及ICGA和FFA在AION诊断和研究方面的价值。方法对比分析AION患者31例32只眼和非AION眼底病患者38例38只眼ICGA＆FFA同步检查的图 像以及AION患者的视野检查资料。结果AION组中视盘全部或 部分位于脉络膜血液供应分水带内的眼数显著多于非AION (P<0.005);所有接受检查眼通过视盘的分水带都为垂直状,视盘两侧脉络膜血管充盈较上下方为快。AION 患者的分水带分型与视盘缺血部位存在明确的对应关系。ICGA早期视盘无荧光 ,晚期视盘缺血区均无荧光,非缺血区主要表现为不均匀荧光。结论AION的发病与盘周脉络膜血液供应状态有关。ICGA在对AION的诊断和研究方面比FFA 具有更大的价值。(中华眼底病杂志,2001,17:111-114)     

小梁切除术后浅前房原因分析

目的:探讨小梁切除术手术后浅前房发发生原因及处理原则。方法:分析小梁切除术手术患者182例308眼发生浅前房的比率及处理方法。结果:小梁切除术术后浅前房38例42眼(13.6%),其中引流过畅21眼、脉络膜脱离17眼,结膜瓣渗漏2眼,恶性青光眼2眼,33眼行保守治疗(78.6%),7眼行前房重建术,1眼行结膜瓣修复,1眼行晶状体摘除术及玻璃体抽吸术。结论:小梁切除术术后浅前房发生率较高,其最常见原因为脉络膜脱离及房水引流过畅,大多数浅前房通过非手术治疗,在前房重建中效果良好。     

中心性渗出性脉络膜视网膜病变ICGA与FFA的对比研究

目的探讨中心性渗出性脉络膜视网膜病变(CEC)的吲哚菁绿血管造影(ICGA)与荧光素眼底血管造影(FFA)的图像特征。方法对43例(43眼)CEC的患者分别行检眼镜、眼底彩色照相、共焦激光视网膜-脉络膜同步血管造影检查。结果41眼(95%)在ICGA与FFA早期同时显示CNV,出现时间平均为(12.42±3.18)s;FFA明确显示CNV的位置;CNV位于中心凹下16眼,中心凹旁27眼,40眼在ICGA早期出现弱荧光区,CNV出现在弱荧光区内;6眼ICGA早期显示病灶周围以及后极部眼底伴有限局性脉络膜血管扩张;27眼伴有神经上皮脱离。34眼(79.1%)在ICGA晚期显示CNV的特征是在其边缘有一环状弱荧光。结论ICGA可准确发现CNV的血管形态,FFA结合ICGA能更准确地评估CNV。     

高度近视眼的吲哚青绿血管造影

目的探讨高度近视眼的吲哚青绿血管造影(indocyanine green angiography,ICGA)图像特征。方法对27例(54只眼)高度近视眼患者分别进行检眼镜、眼底彩色照相、共焦激光荧光素及吲哚青绿(indocyanine green ,ICG)同步血管造影。结果ICGA显示19只眼有漆裂纹,其中10只眼见漆裂纹中间有点、片状脉络膜新生血管(choroidal neovascularization,CNV), 占52．6%。而荧光素眼底血管造影(fundus fluorescein angiography,FFA)仅7只眼有明 显的漆裂纹。ICGA与FFA均显示14只眼有多灶性萎缩,ICGA显示3只眼伴有粗大的脉络膜血管 。结论ICGA可更清楚地显示高度近视眼的脉络膜视网膜的变性萎缩、漆裂纹及并发的CNV,有助于预后的评价。(中华眼底病杂志,2001,17:201-203)     

青光眼小梁切除术后浅前房临床分析

目的探讨小梁切除术后浅前房发生原因及处理方法。方法对不同类型青光眼50例67眼小梁切除术后浅前房20眼进行原因分析及治疗效果观察统计。结果本组67眼小梁切除术后发生浅前房20眼，占29．85％。浅前房的主要原因是术前高眼压和眼部炎症反应。经过非手术综合治疗，均在术后7～15天前房逐渐形成，随访3～30月，眼压控制理想，无严重并发症。结论小梁切除术降压效果肯定，但浅前房发生率高，注意术前降眼压，减轻炎症反应，术中操作准确，可减少浅前房的发生。     

中心性浆液性脉络膜视网膜病变的眼底血管造影

目的 观察中心性浆液性脉络膜视网膜病变tcentral seous chorioretinopathv，CSC)在眼底荧光血管造影(fundus fluorescein angiography，FFA)与吲哚青绿血管造影(indocyanirle green angiography．ICGA)中的动态表现．探讨中心性浆液性脉络膜视网膜病变的发病机理。方法 采用海德堡共焦激光扫描系统(Heidelbetg retina angiography，HRA)对46例CSC患者．行双眼FFA及ICGA检查，分析其结果。结果 46只主检眼中34眼在IC-GA早期见到一处或多处脉络膜血管充盈延迟，46只眼显示后极部一处或多处脉络膜异常高荧光；在FFA中．22只眼在相应位置出现低荧光区，44只眼于相应部位出现点或片状高荧光。对侧眼中42只眼在ICGA过程中出现一处或多处点或片状高荧光区，而FFA中，仅29只眼在FFA中见到点或片状高荧光，其病灶数量明显少于ICGA。部分病例在ICGA和FFA中见视网膜色素上皮及神经上皮脱离区，结论 中心性浆液性脉络膜视网膜病变存在脉络膜循环异常、ICGA与FFA比较，前者在诊断上更有价值。ICGA与FFA对认识中心性浆液性脉络膜视网膜病变的病理过程有重要意义。     

青光眼小梁切除后浅前房的临床分析

目的:分析青光眼小梁切除后浅前房发生的原因及处理方法。方法:106例(116眼)青光眼患者行小梁切除术,术后观察浅前房的发生并予相应处理。结果:116眼中,术后10眼发生浅前房,占8.6%,滤过道引流过畅,缝线松脱、房水渗漏,恶性青光眼是术后浅前房发生的主要原因。术后对并发症相应处理后,10眼发生浅前房均恢复正常。结论:小梁切除术对术前、术后有效地控制眼压,术中保持前房深度,注意伤口缝线的松紧,术后观察眼压及前房的变化,及时对症处理,取得较好效果。