荧光素钠眼底血管造影对低灌注性视网膜病变的诊断作用

目的:分析低灌注性视网膜病变的临床和眼底荧光血管造影(fundus flurescein angiography,FFA)特点,确定FFA对该病的诊断作用。方法:收集经临床检查,眼底荧光血管造影检查和颈部血管彩色超声多普勒(CDI)检查确诊的低灌注性视网膜病变患者共9例9眼。分析3种检查的诊断符合率,并总结该病的眼底荧光血管造影特点。结果:共9例患者中,仅有两例患者在初诊中诊断为低灌注性视网膜病变,其余患者均通过FFA得到确诊。所有患者FFA和颈部血管CDI的诊断均一致,FFA和CDI的诊断符合率达到100%。低灌注性视网膜病变的眼底表现多样但FFA具有特征性,FFA的主要特征包括:(1)臂-视网膜循环时间延长,平均为17.5±10.2s,视网膜动-静脉循环时间也延长,平均为15.5±9.2s;(2)大部分患者视网膜周边部可见大量微动脉瘤、小血管渗漏;(3)静脉可呈串珠状;(4)视网膜新生血管主要位于周边部。结论:低灌注性视网膜病变容易和糖尿病性视网膜病变,高血压性视网膜病变等病混淆。但其特征性的FFA表现可使该病得到确诊。

Diagnostic role of FFA in hypoperfusion retinopathy

AIM: To explore the diagnostic role of fundus fluorescien angiography (FFA) in hypoperfusion retinop-athy (HR) by analyzing clinical and FFA features of HR. ·METHODS: Nine eyes of 9 HR patients were diagnosed by clinical examination, FFA and carotid Doppler ultrasound examination. Characters of HR and diagnose accordance rates of the three examinations were analyzed. ·RESULTS: Only 2 of 9 patients were diagnosed HR by the first clinical examination, other patients were identified by FFA. For all the patients, diagnosis of FFA was in full (100%) consistent with that by Color Doppler imaging (CDI). HR patients displayed multiple fundus appearances, but showed special FFA manifestation, including 1) a delay in arm-to-retinal circulation time and in retinal arteriovenous transit time with mean 17.5±10.2 seconds and 15.5±9.2 seconds, respectively; 2) microaneurysm and small vascular leakage in the periphery retina; 3) bead-like vein; 4) retinal neovascularization mainly in the periphery retina. ·CONCLUSION: HR is easily confused with diabetic retinopathy and hypertensive retinopathy, but its distinctive FFA appearances can make diagnosis correct.