·论著·志2005年第l3卷第5期Journalofclinicaloohthalmolozv.2005.Vo113.No.5交感性眼炎的荧光素眼底血管造影和吲哚菁绿血管造影观察宫媛媛王卫峻严正吴星伟吴颍【摘要】目的观察交感性眼炎的荧光素眼底血管造影(fundusfluoresceinangiography,FFA)和吲哚菁绿血管造影(indocyaninegreenangiography,ICGA)特征。方法选择交感性眼炎患者6例(6只眼),进行FFA与ICGA的同步造影,并随访3月至2年。结果初发病者FFA可出现视盘高荧光渗漏或荧光染色,黄斑暗区扩大,ICGA早期有脉络膜血管扩张,中后期有片状低荧光,或环以高荧光带。治疗后,FFA的渗漏灶可以很快消失,有透荧灶出现,ICGA则改变不明显,上述病灶仍存在,可出现多灶性的低荧光区,持续时间较长。结论交感性眼炎主要表现为脉络膜炎。ICGA可更客观地反映交感性眼炎诊治情况。【关键词】交感性眼炎;荧光素眼底血管造影;吲哚菁绿血管造影FFAandICGAinsympatheticophthalmiaGDYuanyuan,Wangn,YanZheng,eta1.DepartmentofOphthalmology,theAfiliatedFirstPeople~HospitalofShanghaiJiaotongUn~ersi@,Shanghai200080,China【Abstract】ObjecfiveToinvestigatethecharacteristicofsympatheticophthalmiabyisochronousindocyaninegnandfluoresceinangiography(ICGAandFA).Methods6sympatheticophthalmiapatientsincluding6eyeswereexaminedbyHeidelbergretinaangiography(HRA)andfollowedupfrom3to24momhs.Results3eyesofacutestagewithoutanytreatmentmayhavenoobviouschangesinearlyphaseinFFA.Buttheymaypresenthyperfluoreseenceormildfluorescencestainingaroudtheopticdiscorunevenbackgroundinthemidandlatephases.InICGA,theypresentsomehyperfluoresceneeareaintheearlyphaseandhypofluoreseeneeareaaroundbyhyperfluoreseeneeringinthelatephase.Af-tertreatment,therearenoobdo~changesbutsometransmittedfluorescencespotsinFFA.However,thosehypofluores—cenceareaarestille】【istinICGA.ThehypofluorescenceofICGAisprominentandlastinginthefolow—upperiod.Con-clusionThesecharacteristicsofICGAandFAsuggestthatsympatheticophthalmiadisplaysehoroiditismainly.ICGACanofermoreobjectiveevidenceondiagnosisandtherapyaboutthisdisease.【Keywords】Sympathetic;Ophthalmia;Ocularfundusfluoreseeinangiography;Indocyaninegreenangiography交感性眼炎(sympatheticophthalmia)是双侧肉芽肿性葡萄膜炎,仅见于眼球穿通性外伤或眼科手术后。虽然发生率不高,但一旦发生,往往比较严重,且患者往往只有单眼视力,病程迁延,容易复发,对生活影响明显,需要及时的诊断和治疗,其中荧光造影检查具有诊断价值。本次研究即用吲哚菁绿造影(indocyaninegreenangiography,ICGA)及荧光素眼底血管造影(fundusfluoresceinangiography,FFA)就交感性眼炎的眼底造影表现进行观察分析,为临床诊治提供一些客观依据。资料与方法1.研究对象:选择临床诊为交感性眼炎的患者6例,均为男性,年龄在30—55岁之间。其中4例有眼球穿通伤史,1例有眼爆炸伤史,1例有内眼手作者单位:200080上海交通大学附属第一人民医院眼科术史。发病时间最短为10天,最长至9年。交感眼视力从0.12—0.4不等。眼底表现轻者仅有视盘充血和轻度水肿,重者表现有后极部水肿渗出,伴有视网膜脱离。发病时间最长者1例系9年前有左眼球铁屑穿孔伤,在此期间,5年前行白内障摘除和人工晶状体植入术,2年前因人工晶状体移位行人工晶状体置换术,同年又因出现视网膜脱离而再行视网膜脱离手术,就诊时右眼视力已下降3月,当地医院给予激素治疗1月后停用,后再次出现右眼视力下降。2.仪器和记录方法:所有患者先用裂隙灯显微镜进行眼前节检查,用复方托毗卡胺滴眼液(Mydrin—P)充分散瞳后,用直接检眼镜及前置镜作眼底检查;同时进行FFA和ICGA检查。采用德国海德堡共焦激光眼底扫描系统(Heidelbergretinaangiogra—phy,HRA)进行ICGA与FFA造影,图像处理软件为配套的HeidelbergEyeExplorer。经必要的过敏试维普资讯http://www.cqv...