虹膜荧光素血管造影在新生血管性青光眼随访中的应用

目的　观察虹膜荧光素血管造影（iris fluorescein angiography，IFA）在新生血管性青光眼（neovascular glaucoma，NVG）随访中的作用。方法　收集2015年2月至2017年2月在北京大学第三医院随访过程中发现眼压再次升高的NVG患者17例（17眼），其中男10例（10眼），女7例（7眼），年龄（52.2±14.2）岁。视网膜中央静脉阻塞7眼，糖尿病视网膜病变7眼，视网膜分支静脉阻塞2眼，视网膜中央静脉合并动脉阻塞1眼。记录患者的最佳矫正视力、眼压、裂隙灯显微镜检查等资料。行IFA评估患者虹膜新生血管复发的情况，包括新生血管范围、荧光素渗漏程度，并与裂隙灯显微镜检查结果进行对比。结果　本研究发现，通过IFA观察到17例（17眼）患者均存在虹膜新生血管，其阳性率为100.0%；依据荧光素渗漏的情况对患者的病变进行分级，其中轻度12例12眼，中度4例4眼，重度1例1眼。裂隙灯显微镜检查结果显示12例（12眼）患者存在明显的虹膜新生血管，5例（5眼）患者未观察到明显的新生血管，其阳性率为70.6%。两种检查方法的阳性率比较差异具有统计学意义（P=0.022）。IFA所显示的新生血管范围大于裂隙灯下观察的结果。结论　IFA有助于NVG患者新生血管复发的早期诊断，在NVG随访中有十分重要的作用。

Iris fluorescein angiography for recurrent neovascular glaucoma

Objective　To evaluate the effects of iris fluorescein angiography (IFA) in the follow-up of neovascular glaucoma (NVG) patients.Methods　NVG Patients with recurrent intraocular pressure (IOP) out of control were enrolled from February 2015 to February 2017 in Peking University Third Hospital.Seventeen patients were enrolled with 10 males (10 eyes) and 7 females (7 eyes),with age of (52.2±14.2)years.The diagnosis included 7 eyes of central retinal vein occlusion (CRVO),7 eyes of proliferative diabetic retinopathy,2 eyes of branch retinal vein occlusion,and 1 eye of combined central retinal artery occlusion and CRVO.The general information,best corrected vision acuity (BCVA),IOP,neovascularization of iris and the retinal diseases were recorded.IFA was performed to evaluate the severity of neovascularization in iris,which was compared with the results by slit lamp.Results　IFA confirmed iris new vessels in all 17 patients including 12 mild cases,4 moderate cases and 1 severe case.Iris new vessels were found only in 12 patients by slit lamp.The positive rate of iris new vessels by slit lamp examination is 70.6% while 100.0% by IFA,with statistically significant difference (P=0.022).The severity of iris new vessels was more extensive by IFA than by slit lamp.Conclusion　IFA plays an important role in the follow-up for NVG.Timely IFA may help to confirm the recurrent iris new vessels,assessment of severity of illness and early treatment.