孤立性脉络膜血管瘤的荧光素钠吲哚青绿同步眼底血管造影

目的探讨孤立性脉络膜血管瘤荧光素钠及吲哚青绿同步眼底血管造影的影像学特征及其临床意义,为诊断及治疗监测提供依据。方法应用海德堡HRA2共焦激光扫描眼底血管造影系统对9例9眼孤立性脉络膜血管瘤进行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,分析比较2种检查影像学特征。结果FFA检查主要影像学表现为动脉前期或动脉早期瘤体部位血管丛状或斑状高荧光;静脉期高荧光灶渗漏融合;晚期瘤体呈弥漫性强荧光。其中3例瘤体表面夹杂不规则的点片状低荧光;6例瘤体表面及周围视网膜毛细血管扩张;5例可见与瘤体周围RPE带状萎缩相应的透见荧光。ICG早期可见瘤体由不规则血管网状高荧光组成;中期瘤体呈强荧光团;晚期所有病例均有特征性的"冲洗现象"。ICGA比FFA更清晰显示瘤体范围。结论孤立性脉络膜血管瘤ICGA影像比FFA影像更具特征性,能够更清晰地显示肿瘤边界;FFA则能显示视网膜血管及RPE的继发性损伤。FFA和ICGA同步检查对孤立性脉络膜血管瘤临床诊断、治疗及疗效监测有重要的指导意义。

Simultaneous fundus fluorescein and indocyanine green angiography in circumscribed choroidal hemangiomas

Objective To investigate the iconographic characteristics of fundus fluorescein angiography ( FFA ) and indocyanine green angiography ( ICGA ) in circumscribed choroidal hemangiomas. Methods 9 eyes of 9 patients with circumscribed choroidal hemangiomas were examined by FFA and ICGA simultaneously with HRA2 confocal scanning laser ophthalmolscope. Results FFA showed that the tumor was composed of vasculature hyperflurescene during the arterial phase; copious dye leakage appeared in venous phase and persisted into the late phase of angiography. 3 eyes showed hypoflurescene spots, 6 eyes showed the retianal capillary dilatation on the tumor and 5 eyes showed window defect from RPE atrophy around the tumor. ICGA revealed that the vascular tissue of the hemangioma filled rapidly with dye during the early phase, and "wash-out" phenomenon could be observed in the late phase of angiography. Among the 9 eyes, 8 of them could be better defined in ICGA than in FFA. Conclutions ICGA reveals more iconographic characteristics than FFA for circumscribed choroidal hemangiomas, and FFA may show much more secondary retinal injuries. Simultaneous FFA and ICGA is an important technique in diagnosis, treatment and followup of circumscribed choroidal hemangiomas.