眼底血管样条纹临床及荧光造影表现

目的 分析眼底血管样条纹(angioidstreaks,AS)的临床特征与眼底荧光血管造影(fundus fluorescein angiography,FFA)及吲哚青绿血管造影(fundus indocyanine green Angiography,ICG)表现.方法 对7例(14只眼)血管样条纹患者行眼科常规检查,眼底照相.其中6例(12只眼)患者行FFA及ICG检查.结果 眼底表现:14只眼眼底见视盘周围血管样放射状条纹,7只眼黄斑区视网膜下出血,黄白色硬性渗出,大小不一的灰黄色病灶(50.00%),3只眼见黄斑区萎缩瘢痕灶(21.43%);FFA表现:血管样条纹10眼表现为透见荧光(83.33%),2只眼表现为中央低荧光,两侧高荧光(16.67%),7只眼在黄斑区出现脉络膜新生血管(choroidalneovascularization,CNV)的强荧光(58.33%),3只眼黄斑区萎缩瘢痕灶晚期荧光着染(25.00%);ICG表现:12只眼血管样条纹表现为早期不显影,中期呈强荧光,7只眼CNV表现为强荧光,3只眼黄斑区萎缩瘢痕灶中2只眼见边界不清斑状CNV.结论 眼底血管样条纹患者的眼底较典型,FFA及ICG能进一步明确诊断,对疾病治疗有指导意义.     

眼底血管样条纹13例眼底荧光造影特征与临床表现

目的:分析眼底血管样条纹(angioid streaks,AS)的临床特征与眼底荧光造影(fundus fluorescein angiography,FFA)表现,并发症及治疗预后。方法:分析13例26眼血管样条纹患者的临床表现,全身状况及眼底荧光造影表现。结果:有11眼视力≤0.3(42%);眼底表现:26眼后极部均可见类似血管样的放射状条纹,5眼(19%)斑驳状(桔皮状)外观,15眼(58%)条纹通过黄斑,10眼(38%)可见黄斑区视网膜下出血、硬性渗出及新生血管膜,1眼(4%)合并眼外伤致多发性脉络膜破裂出血。FFA:26眼血管样条纹均表现为透见荧光,11眼黄斑在造影早期见脉络膜新生血管(choroidal neovascularization,CNV)影,其亮度逐渐增强,后期渗漏明显。结论:眼底血管样条纹患者的眼底及FFA表现典型,FFA结果有助于诊断分期及指导治疗。     

眼底荧光血管造影在1期糖尿病视网膜病变诊断中应用价值

目的 探讨糖尿病视网膜病变(DR)国际临床分类法1期病变患者眼底荧光血管造影(FFA)表现,评价FFA对早期DR的诊断价值.方法 对76例(152只眼)诊断为糖尿病视网膜病变国际临床分级标准1期病变患者进行眼底及眼底荧光血管造影检查,分析其造影表现.结果 检眼镜下152只眼眼底全部未见异常表现,FFA正常48只眼(31.58%).FFA异常104只眼(68.42%),异常表现中单纯微动脉瘤(MA)强荧光56只眼(53.84%),MA合并毛细血管扩张15只眼(14.41%),MA合并黄斑水肿5只眼(4.81%),黄斑拱环破坏3只眼(2.87%),小片状毛细血管无灌注2只眼(1.92%),窗样缺损23只眼(22.15%).结论 被诊断为DR国际临床分类法1期的患者,大部分已经出现了不同程度的FFA异常表现.因此,FFA是DR早期诊断的较好方法,能提高对DR早期诊断的准确度.

Abstract：

Objective To investigate the fundus fluorescence angiography (FFA) performance of diabetic retinopathy (DR) according to the international clinical classification of period l's patients. To evaluate the diagnostic value of FFA in early DR. Methods Fundus and fundus fluorescence angiography examination were performed and analyzed in 76 of period 1 patients (152 eyes) for the diagnosis of diabetic retinopathy according to the international clinical classification standard of. Results All 152 eyes fundus had no abnormal performance under ophthalmoscope, FFA normal 48 eyes (31.58%); FFA abnormal 104 eyes (68.42%), abnormal performance among a simple micro-aneurysms (MA), high fluorescence 56 eyes (53.84%), MA merge in telangiectasia 15 eyes (14.41%), MA merge in macular edema 5 eyes (4.81%), macular arch ring had damaged 3 eyes (2.87%), small flake with capillary nonperfusion 2 eyes (1.92%), window defect 23 eyes (22.15%).Conclusions DR is diagnosed with period 1 patients according to the international clinical classification, most of the emergence of difference degrees abnormal performance of the FFA. Therefore, FFA is the better method in early diagnosis of DR. It can increase the accurate of diagnosis for DR.     

儿童遗传性视网膜疾病的眼底自身荧光表现

目的 观察儿童遗传性视网膜疾病的眼底自身荧光(FAF)特征.方法 回顾性分析22例临床资料完整、年龄5～14岁之问的遗传性视网膜疾病患儿的FAF检查结果.其中,Best卵黄样病变8例16只眼,Stargardt病3例6只眼,视锥细胞营养不良3例6只眼,原发性视网膜色素变性(RP)5例10只眼,X连锁青少年型视网膜劈裂症3例6只眼.仔细询问现病史及家族史,行视力、裂隙灯显微镜眼前节检查,间接眼底镜检查,彩色眼底像和FAF照相,其中部分患儿接受了荧光素眼底血管造影(FFA)、视网膜电流图、眼电图、光相干断层扫描检查.对上述患儿的FAF结果特征进行归纳总结,并与其眼底照相和/或FFA结果进行比较分析.结果 3例Stargardt病患儿的6只眼及3例视锥细胞营养不良患儿的6只眼FAF检查显示黄斑区可见对称性的圆形、近圆形弱荧光或荧光缺如区,2例视锥细胞营养不良患儿的4只眼及1例Stargardt病患儿的2只眼可见弱荧光或荧光缺如区外缘环以强荧光;Best卵黄样病变患儿黄斑区可见一个强度均匀或不均匀的强FAF病灶;RP患儿后极部视网膜FAF增强,黄斑区周围可见宽度不等的环形强荧光带,拱环区FAF正常;3例X连锁青少年型视网膜劈裂症患儿中5只眼中心凹部位FAF检查可见蜂窝或颗粒状强荧光.结论 Stargardt病及视锥细胞营养不良患儿黄斑区为近圆形弱荧光,部分病变区外缘环以强荧光;Best卵黄样病变患儿黄斑区为强度均匀或不均匀的强FAF病灶;RP患儿后极部视网膜FAF增强,拱环区FAF正常,黄斑区周围可见宽度不等的环形强荧光带;X连锁青少年型视网膜劈裂症患儿中心凹部位为蜂窝或颗粒状强荧光.

Abstract：

Objective To observe the autofluorescence (AF) manifestation in children with hereditary retinal diseases. Methods The clinical data of 22 children (aged from 5 to 14 years) with hereditary retinal diseases were retrospectively analyzed. There were 8 children (16 eyes) with Best vitelliform macular dystrophy, 3 children (6 eyes) with Stargardt macular dystrophy, 3 children (6 eyes) with macular cone dystrophy, 5 children (10 eyes) with primary retinitis pigmentosa, and 3 children (6 eyes) with X-linked juvenile retinoschisis. The routine clinical examinations included present history, family history, visual acuity, silt-lamp microscopy, indirect ophthalmoscopy, color fundus photography and fundus autofluorescence angiography (FAF). Some patients received fundus fluorescein angiography (FFA),electroretinogram (ERG), electrooculogram (EOG), and ocular coherence tomography (OCT). The characteristics of AF in all the children were analyzed, and were compared with the images of color fundus and/or FFA. Results Symmetry round macular fluorescent weak or absent area was found in all Stargardt disease and cone dystrophy. Weak AF area with surrounded circular increased AF was found in 2 children (4 eyes) with cone dystrophy and 1 child (2 eyes) with Stargardt macular dystrophy. A central round area with regular or irregular intense AF was observed in Best vitelliform macular dystrophy. RP children showed increased AF out of the macular region. Cellular or granular strong AF was found in the fovea of 3 children (5 eyes) with X-linked juvenile retinoschisis. Conclusion The children with hereditary retinal diseases had special AF changes.     

原田病药物治疗后吲哚青绿眼底血管造影观察

目的 探讨利用吲哚青绿血管造影检查作为原田(Harada)病临床观察指标的意义.方法 对经药物治疗后19例(38只眼)原田病患者同时行荧光素眼底血管造影(fundus fluorescein angiography,FFA)及吲哚青绿血管造影(indocyanine green angiography,ICGA)检查资料进行分析.结果 FFA检查发现有4例(8只眼)视盘轻度染色,视网膜未发现异常改变;ICGA早期及中期无异常表现,但后期8只眼(包括FFA中视盘染色的4只眼)在中周及后极部出现了点状或斑片状弱荧光;3例6只眼FFA及眼底正常,在ICGA后期后极部出现了斑点状弱荧光;24只眼脉络膜大、中血管影像减少,其中12只眼dalen-fuchs结节着色.结论 ICGA可较好提供原田病的脉络膜循环损害的信息,并在评价疗效上有意义.

Abstract：

Objective To investigate the clinical value of indocyanine green angiography(ICGA)in patients with Harada disease.Methods Fundus fluorescein angiography(FFA)and indocyanine green angiography(ICGA)were used for comparative analyses in 26 cases(52 eyes)of Harada disease after treatment.Results Mild dyeing in disk was found only in 4 cases(8 eyes),and the others were not found any abnormal in FFA.There were no any abnormal found in early period and middle period of ICGA,but of 8 eyes(include 4 eyes of dyeing in disk in FFA)multifocal lower fluorescence were found in the mid-periphery and posterior pole of the fundus in the late phase.Of 3 cases(6 eyes)were normal in FFA,however multifocal lower fluorescence were found in the posterior pole of the fundus in the late phase of ICGA.Of 24 eyes were found decreased fluorescence in large and middle choroidal vessel,and 12 eyes of Dalen-Fuchs were colored.Conclusions ICGA may assist in providing valuable information on choroidal circulation of Harada disease and be useful in evaluating the curative effects.     

Characteristics of Indocyanine Green Angiography in Exudative Age—related Macular Degeneration

Objective: To observe the characteristics of indocyanine green angiography (ICGA) in exudative age-related macular degeneration (AMD).Methods: Thirty-one cases (39 eyes) were diagnosed as exudative AMD by ocular examination, fundus color photography, fundus fluorescein angiography (FFA) and ICGA. Their ages ranged from 50 to 82 years and visual acuities from FC/30cm to 0. 7. We analyzed and compared the characteristics of ICGA and FFA in these patients. Results: Of 26 eyes with occult choroidal neovascularization (CNV) by FFA, 15 (57. 7% ) had classic CNV by ICGA. Of 4 eyes with serous retinal pigment epithelial detachment (FED) without CNV by FFA, 1 had serous FED with classic CNV by ICGA. The hyperfluorescence of the scar staining was detecfed by ICGA. Conclusion ? ICGA adds clinically useful information and is an important adjunct in the evaluation, classification, and laser treatment of patients with occult CNV in AMD. Eye Science 1999; 15: 156 - 161.     

家族性渗出性玻璃体视网膜病变的荧光素眼底血管造影特征及其诊断价值

目的 观察家族性渗出性玻璃体视网膜病变(FEVR)的荧光素眼底血管造影(FFA)特征,评价FFA对FEVR的诊断价值.方法 经临床检查诊断为FEVR的患儿34例68只眼及其父母64名128只眼纳入本研究.所有受检者均采用裂隙灯显微镜检查眼前节、间接检眼镜检查眼底.患儿同时应用RetcamⅡ视网膜成像系统检查眼底,患儿父母同时行最佳矫正视力检查.根据以上检查表现,对患儿及其父母行FEVR分期.采用RetcamⅡ视网膜成像系统在全身麻醉状态下对患儿行FFA检查;用海德堡HR2眼底血管造影设备对患儿父母行常规FFA检查.观察患儿及其父母不同分期FEVR的FFA特征.结果 患儿68只眼中,正常者3只眼,占4.41%;1期4只眼,占5.88%;2期7只眼,占10.29%;3期2只眼,占2.94%;4期8只眼,占11.76%;5期44只眼,占64.71%.患儿父母128只眼中,正常者74只眼,占57.81%;1期51只眼,占39.84%;2期1只眼,占0.78%;A;5期2只眼,占1.56%.患儿FFA检查发现,1期主要表现为视网膜血管发育不完全,未发育至周边即终止,视网膜周边无灌注.2期在1期FFA表现的基础上,在视网膜异常吻合处有新生血管形成和(或)视网膜渗出异常.3期在2期FFA表现的基础上,存在玻璃体牵引诱发的周边视网膜脱离,但未累及黄斑.4期主要表现为累及黄斑的视网膜脱离.5期主要表现为全视网膜脱离.患儿父母FFA检查发现,1期主要表现为视网膜血管近赤道部突然中止,出现周边无灌注区.2期在1期FFA表现的基础上,在视网膜无灌注区附近有动静脉短路和新生血管形成和(或)视网膜下渗漏.5期主要表现为眼球萎缩.结论 不同分期的FEVR存在不同程度的FFA特征表现;FFA检查可以发现FEVR患者的早期眼底改变,具有重要的诊断价值.

Abstract：

Objective To investigate the characteristics and diagnostic value of fundus fluorescein angiography(FFA)for familial exudative vitreoretinopathy(FEVR).Methods 34 children(68 eyes)with FEVR and 64 parents(1 28 eyes)were included.All the clients were received examinations of slit-lamp biomicroscopy and indirect ophthalmoscopy.Meanwhile the children were examined by Retcam Ⅱ,the best corrected visual acuity of parents were recorded.The children and their parents were classified according to the ocular findings.Among 68 eyes of children,3 eyes(4.41% )were normal,4 eyes(5.88% )were in stage 1,7 eyes(10.29% )were in stage 2,2 eyes(2.94% )were in stage 3,8 eyes(11.76% )were in stage 4 and 44 eyes(64.71% )were in stage 5.Among 128 eyes of parents,74 eyes(57.81% )were normal,51eyes(39.84% )were in stage 1,1 eyes(O.78% )were in stage 2 and 2 eyes(1.56% )were in stage 5.FFA was performed on the children with RetcamⅡunder anesthesia and on the parents with HR2 in order to observe the FFA characteristics in different stage.Results FFA characte ristics in children included uncompleted vascularization of the periphery,peripheral avascular zone(stage 1);neovascularization and/or peripheral subretinal and intraretinal exudation(stage 2);subtotal retinal detachment with attached foyea (stage 3);subtotal retinal detachment with detached foyea(stage 4)and total retinal detachment(stage 5).FFA characteristics in parents included abrupt cessation of the peripheral retinal capillary network and a peripheral avascular zone(stage 1); abnormal peripheral arteriovenous shunts, neovascularization or exudation(stage 2)and atrophia bulbi(stage 5).Conclusions FEVR in different stage has different FFA characteristics.FFA plays an important role in early diagnosis of FEVR.     

光学相干断层扫描在光动力疗法治疗中心性渗出性脉络膜视网膜病变的应用

目的 探讨光学相干断层扫描(optical coherence tomography,OCT)对光动力疗法(photodynamic terapy PDT)治疗中心性渗出性脉络膜视网膜病变(central exudative chorioretinopathy,CEC)脉络膜新生血管(choroidal neovascularization,CNV)的临床应用价值.方法 对CEC患者45例(46只眼)进行光学相干断层扫描,荧光素眼底血管造影(fundus fluorescein angiography,FFA),吲哚青绿脉络膜血管造影(indocyanine green angiography,ICGA)检查.根据FFA,ICGA和OCT检查结果,明确CNV位置、范围和大小.PDT治疗按维替泊芬PDT治疗(VIP)研究组的方法 进行.并对其疗效进行评价.结果 光动力疗法(PDT)治疗后视力提高者13只眼,占28.26%;视力稳定不变者22只眼,占47.82%;视力下降者11只眼,占23.92%.OCT复查结果 为14只眼(3044%)黄斑水肿消失;18只眼(39.13%)黄斑水肿减轻;10只眼(21.73%)无变化;4只眼(8.7%)黄斑冰肿加重.CNV消失15只眼(32.61%),CNV缩小24只眼(52.17%),CNV无变化4只眼(8.7%),CNV增大3只眼(6.52%).治疗后视网膜厚度明显变薄(P<0.01).黄斑中心凹视网膜神经上皮层厚度与视力呈负相关(r=0.4963,P<0.01).结论 OCT可客观、精确地显示CNV的位置、大小、范围及视网膜水肿的变化程度,对指导光动力疗法(PDT)治疗中心性渗出性脉络膜视网膜病变(CEC)脉络膜新生血管(CNV)的疗效评价有着重要价值.

Abstract：

Objective To verify the applicable significance of optical coherence tomography (OCT)photodynamic therapy (PDT) for central exudative chorioretinopathy (CEC) choroidal neovascularization (CNV). Methods Forty-five cases (46 eyes) of central exudative chorioretinopathy (CEC) were managed with PDT. Before and post-treatment, all cases underwent OCT, fiuorescein angiography (FFA) and indocyanine green angiography (ICGA). PDT treatment was in accordance with the PDT verteporfin therapy (VIP) Study Group methods. Results The visual acuities of last visit were compared with those before the treatment. The visual acuity was improved in 13eyes (28.26%), unchanged in 22 eyes (47.82%), and declined in 11 eyes (23.92%). OCT was re-done and compared with OCT images before PDT treatment. The macular edema was disappeared in 14 eyes (30.44%), decreased in 18 eyes (39.13%), unchanged in 10 eyes (21.73%), and increased in 4 eyes (8.7%). CNV was disappeared or decreased in 39 eyes (84.78%), unchanged in 4 eyes (8.7%),and progressed in 3 eyes (6.52%). The retinal thickness was decreased obviously (P ＜0.001). The statistical analysis showed there was a negative correlation between the thickness of fovea and visual acuity (r =0.4963, P =0.001). Conclusions OCT can precisely show the location, size and changes of retinal thickness and has an important significance in PDT treatment for CEC.     

息肉状脉络膜血管病变在眼底FFA 与ICGA中特征分析

目的 探讨息肉状脉络膜血管病变(PCV)眼底荧光素血管造影(FFA)和吲哚青绿血管造影(ICGA)同步检查的影像学特征及其临床意义.方法 选取62例患者(75只眼)进行眼底彩色照相、FFA 和ICGA同步检查,对黄斑部视网膜下出血病灶其形态及特征做以对比分析.结果 FFA图像显示:PCV75只眼中斑块样视网膜下出血48只眼,占64.0%;伴浆液性视网膜色素上皮(RPED)脱离12只眼,占16.0%;出血性RPED8只眼,占10.7%;脉络膜血管网及息肉样结节7只眼,占9.4%,早期即出现荧光素渗漏并逐渐增强,CNV末端膨大处出现点状高荧光.ICGA图像显示:75只患眼中72只眼呈"蘑菇"状或"树枝"状异常扩张,其血管网末端多个息肉样膨大与彩色照相所见的结节样病变部位吻合.结论 FFA和ICGA同步检查,不但对PCV患者病灶其形态及特征作出对比分析,ICGA检查还能提高PCV视网膜下脉络膜新生血管膜(CNV)的检出率,同时提高PCV患者激光光凝的可能性,而FFA对评估PCV 视网膜下出血及出血性或浆液性视网膜色素上皮脱离、脉络膜血管网及息肉状结节则均有较好的效果.

Abstract：

Objective To observe on fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) in polypoidal choroidal vasculopathy (PCV), and sync examine of its image features and clinical meaning. Methods Sixty-two patients (75 eyes) applied fundus camera, FFA and ICGA synchronous examination, do comparison analysis in macular sub-retinal hemorrhage shape and area. Results FFA image in 75 PCV patients showed 48 eyes (64.0%) with plaque sub-retinal hemorrhage, 12 eyes (16.0%) accompanied with retinal pigment epithelial detachments (RPED), 8 eyes (10.7%) with bleeding RPED, 7 eyes (9.4%) with choroid blood vessel net and polypoidal node of early stage flouresence leakage. ICGA showed that 75 eyes had abnormal choroid blood vessel net extension, 72 with "mushroom" shape or "tree-branch" shape with more polypoidal enlarge in the end which was the same as seen under ophthalmoscope. Conclusions It proves that FFA and ICGA synchronous examination, not only can be used for PCV patients' tissue shape and area comparison analysis, but also improves the finding rate of the choroidal neovascularization (CNV) in PCV, increases the feasibility of photocoagulation to PCV. FFA gives good result to evaluate PCV sub-retinal hemorrhage.     

Fundus Analysis and Visual Prognosis of Macular Hemorrhage in Pathological Myopia without Choroidal Neovasculopathy

Purpose:To analysis and evaluate the fundus characteristics and visual prognosis of macular hemorrhage in pathological myopia without choroidal neovasculopathy.Methods:Thirty-seven patients (38 eyes) of pathological myopia with macular hemorrhage and without choroidal neovascularization (CNV) underwent color photograph and fundus fluorescein angiography (FFA) examinations. Indocyanine green angiography (ICGA) was also performed on 11 patients (11 eyes). Follow-up ranged from 3 to 21 months.Results :The macular hemorrhage in pathological myopia without CNV demonstrated oval, less than 1PD, without edema and exudation. Lacquer cracks appeared at the site of previous subretinal bleeding in 84.2% of the eyes. The visual acuities were improved in 81.6% of eyes during the follow-up period. ICGA revealed linear hypofluorescence in 7 of 11 eyes (63.6%), indicating a ruptured Bruch‘s membrance at the onset of subretinal bleeding.Conclusion : A rupture of choriocapillaris complex and Bruch‘s membrane causes macular hemorrhage of pathological myopia without CNV,leading to the formation of a new lacquer crack.Its prognosis is favorable.     

特发性眼底血管样条纹的临床特征

目的分析特发性眼底血管样条纹的临床特征。方法分析13例（26眼）特发性眼底血管样条纹患者的临床表现、荧光素眼底血管造影（FFA）及黄斑区光学相干断层扫描（OCT）表现。结果11眼视力≤0.3,占42.31%。26眼眼底后极部均可见类似血管样的放射状条纹,5眼为斑驳状外观,占19.23%;17眼条纹通过黄斑,占65.38%;1眼（3.8%）合并眼外伤致多发性脉络膜破裂出血。FFA显示26眼血管样条纹均表现为透见荧光,11眼黄斑区可见脉络膜新生血管（CNV）影,其亮度逐渐增强,后期有明显的荧光素渗漏。黄斑区OCT检查发现11眼有CNV表现。Ⅰ型CNV（生长于RPE光带下）：表现为在隆起的视网膜色素上皮（RPE）和脉络膜毛细血管层光带下有不均匀的中或高反射带;混合型CNV：表现为CNV侵入RPE光带及视网膜神经上皮层下空间,RPE光带中断,呈现边界不清的高反射组织。结论眼底、FFA及OCT典型表现的综合分析有助于特发性眼底血管样条纹的诊断、分期及治疗指导。     

Optical coherence tomography (OCT) and angiography in patients with angioid streaks

PURPOSE: To investigate the retinal and choroidal features of angioid streak by fluorescein angiography (FA), indocyanine green angiography (ICG-A) and optical coherence tomography (OCT). METHODS: We analysed 46 eyes of 23 patients with angioid streaks examined at our retina section between March 1998 and June 2000. Their mean age was 42.8 years (26-61 years). After a routine ophthalmological examination, OCT and simultaneous fluorescein and indocyanine green angiography (FA/ICG-A) were done. Color fundus photographs were also taken. RESULTS: A peau d'orange appearance and angioid streaks were more numerous and apparent with ICG-A than FA. In two eyes (4.3%), some streaks that were well visualized on FA were not visible on ICG-A. Twenty eyes (43.5%) had macular complications and 26 (56.5%) were normal. Occult choroidal neovascularization (CNV) was diagnosed by ICG-A. Nine eyes had occult, and 11 had classic CNV Ruptures of Bruch's membrane were hypofluorescent in 20 (43.5%) and hyperfluorescent in 26 eyes (56.5%). Optic disc drusen were detected in both eyes of one patient (4.3%). Localized hyperreflectivity was thought to be due to calcium deposits. CONCLUSIONS: Angioid streaks were visualized more clearly and in larger numbers by ICG-A than FA. However, in some cases streaks that were funduscopically and fluorescein angiographically visible could not be seen by ICG-A. Occult CNV was detected by ICG-A. Some mottled areas were seen and more clearly visualized by ICG-A. Calcium deposits were observed as localized areas of hyperreflectivity on OCT. These findings indicate that fluorescein angiography, ICG-A and optical coherence tomography all provide supportive information for each other and can be used for either diagnosis or follow-up of those patients.     

Indocyanine green angiographic findings in young patients with Grönblad-Strandberg syndrome

PURPOSE: The objective of the present investigation was to define the indocyanine green (ICG) angiographic features of angioid streaks (AS) in young patients with Gr?nblad-Strandberg syndrome and to compare them with findings on fluorescein angiography (FA) and red-free photographs. METHODS: Complete ophthalmological examination, red-free photography, FA and ICG angiography were performed on 6 patients, 4 women and 2 men, ranging in age from 21 to 33 years, with Gr?nblad-Strandberg syndrome. RESULTS: ICG angiography showed AS in the form of hypofluorescent lines with numerous associated hyperfluorescent foci. The AS were more clearly visualized and were seen to be more numerous and larger by ICG angiography. Choroidal neovascularization (CNV) and macular involvement had become bilateral in all of the cases. ICG angiography allowed precise localization of CNV in some cases, but it was not much superior to FA in the determination of CNV and the visualization of 'peau d'orange'. CONCLUSIONS: ICG angiography provides some information different from FA in the evaluation of AS, but usually neovascular complications and peau d'orange appearance could be seen more clearly in the red-free photographs and FA. The hypofluorescent AS pattern was significantly observed in young patients with Gr?nblad-Strandberg syndrome.     

Comparison of fluorescein and indocyanine green angiography in angioid streaks

· Background: The main cause of vision loss in patients with angioid streaks is choroidal neovascularization and subsequent macular degeneration. Indocyanine green angiography allows visualization of the choroidal circulation and may be superior to fluorescein angiography in the evaluation of patients with angioid streaks. · Methods: The ophthalmoscopic, fluorescein and indocyanine green angiographic characteristics of angioid streaks were studied in 34 patients with such streaks. Nineteen patients had pseudoxanthoma elasticum and 15 patients had isolated angioid streaks. The fluorescence characteristics of the ’peau d’orange’ and of choroidal neovascularization, when present, were also analyzed. · Results: Angioid streaks may be hyperfluorescent, hypofluorescent or invisible on indocyanine green angiography. Hyperfluorescent streaks were found in 88% of eyes, hypofluorescent streaks in 11%; in 18% of eyes some streaks were not visualized by indocyanine green angiography. The peau d’orange stained as a speckled pattern in the midperiphery; the flecks were concentrated temporal to the macula. Eighteen eyes presented classic and 6 occult choroidal neovascularization. In several eyes a plaque-like lesion was seen on indocyanine angiography that did not correspond to occult choroidal neovascularization on fluorescein angiography. · Conclusion: Indocyanine angiography outlines angioid streaks as well as the peau d’orange appearance better than fluorescein angiography in the majority of cases. In some cases, however, funduscopically visible streaks can not be visualized. Sometimes classic choroidal neovascular membranes are not visualized by conventional indocyanine green angiography. Occult choroidal neovascularization is better defined by indoycanine green angiography. The fluorescence of angioid streaks and of plaque-like lesions makes the interpretation of indocyanine green angiography difficult. Received: 18 April 1997 Revised version received: 18 August 1997 Accepted: 18 August 1997     

渗出型老年黄斑变性的吲哚菁绿血管造影图像特征

目的 探讨渗出型老年黄斑变性(AMD)吲哚菁绿血管造影(ICGA)与荧光素眼底血管造影(FFA)比较的图像特征。方法 对52例65眼渗出型AMD患者进行了眼底彩色照相、FFA和ICGA检查。结果 渗出型AMD的65眼中，ICGA诊断为典型性脉络膜新生血管(CNV)有33跟．占50．8％，FFA诊惭为典型性CNV有8眼，占11．6％；FFA诊断为隐匿性CNV的35眼中，ICGA诊断为边界清楚或久清楚的斑状CNV有22眼；合并黄斑出血39眼中，FFA不能发现的CNV而ICGA能发现共5眼；FFA诊断为痕痕染色的7眼中，有2眼有ICGA中发现CNV；ICGA发现CNV的供养血管(feeding vessel)有3眼。结论 ICGA比FFA发现CNV诊断率高，准确地显示黄斑出血所掩盖的CNV，ICCA有助丁发现CNV的供养血管。     

眼底血管样条纹并发脉络膜新生血管的临床特征及联合治疗

目的 分析眼底血管样条纹（AS）并发CNV的临床特征,探讨光动力疗法（PDT）联合玻璃体腔注射雷珠单抗治疗AS合并黄斑病变的临床疗效及安全性。方法 回顾性系列病例研究。分析21例（42眼）AS的临床资料,包括BCVA、眼底表现、FFA、ICGA以及OCT。其中18例（22眼）合并黄斑CNV,先采用PDT治疗,3 d内玻璃体腔注射雷珠单抗,治疗后定期随访,至少随访12个月。随访时如发现视力下降、黄斑区出现新病灶、视网膜下或层间积液、CNV活动性病变,则重复玻璃体腔注射。数据采用独立样本t检验或配对样本t检验进行分析。结果 本组21例患者均双眼发病,仅5例（24%）合并全身病变,男性为主（76%）,其中18例（86%）继发黄斑CNV,BCVA显著低于病变未侵及黄斑者。联合治疗的22眼末次随访时BCVA较治疗前提高10.4个字母;OCT示治疗后黄斑区视网膜厚度从基线的（338.4±55.2）μm降至（212.6±36.2）μm;FFA（ICGA）显示15眼（68%）CNV完全闭合,渗漏消失,5眼呈瘢痕染色。所有患者接受1次PDT,平均玻璃体腔注射次数3.2次。1例PDT后出现黄斑区视网膜下出血,行玻璃体腔注射雷珠单抗后出血吸收,5例发生一过性眼压升高,4例出现结膜下出血,均完全恢复,无其他明显眼部及全身不良反应。结论 眼底AS具有特殊的眼底表现,FFA（ICGA）有助于明确诊断,相当比例的患者可继发黄斑部CNV。PDT联合玻璃体腔注射雷珠单抗能有效控制AS合并黄斑病变的病情进展,显著改善患者视功能,减少CNV渗漏,且不良反应少。     

Knobby-like choroidal neovascularization accompanied with retinal pigment epithelial detachment]

PURPOSE: To evaluate the clinical features of knobby choroidal neovascularization (CNV) which was detected using indocyanine green (ICG) angiography and the association between knobby CNV and idiopathic polypoidal choroidal vasculopathy (IPCV). METHOD: We studied 164 eyes with retinal pigment epithelial detachment (PED) accompanied with CNV. These patients were older than 50 years. We detected knobby CNV in 96 eyes of 164 PED eyes (58.5%). Knobby CNV was defined as follows: knobbed blood vessels were observed from the early phase and remained hyperfluorescent through the ICG angiography. We classified 3 groups on the basis of the types of vessels with knobby CNV: group I, multiple isolated knobby CNVs without continuous vessels (24 eyes); group II, knobby dilatations in some parts of CNV (45 eyes); group III, network vessels ending in multiple aneurysmal swelling as in IPCV (27 eyes). RESULT: We found knobby CNV in only 20% of eyes with serous PED, but about 70% in neovascular, serosanguineous, and hemorrhagic PED. The ratio of each group showed no distinction statistically. Knobby CNV mostly appeared in macular areas, and was frequently accompanied with subretinal or subpigment epithelial hemorrhage. Subretinal reddishorange lesions were seen in 50% of group I, 60% of group II, and 89% of group III. Knobby CNV showed occult CNV in fluorescein angiography. In late phase ICG angiography, knobby CNV leaked ICG. New lesions occurred in all groups. CONCLUSION: We think that knobby CNV is a common finding in subpigment epithelial neovascularization, and that IPCV vascular lesion is one type of subpigment epithelial neovascularization.     

Indocyanine green and fundus fluorescein angiographic findings in patients with active ocular Behcet's disease

PURPOSE: To define the indocyanine green (ICG) and fundus fluorescein angiographic (FFA) features of Beh?et's disease. METHODS: The study included 49 eyes of 25 patients (19 males, 6 females; mean age: 34.1 years; age range: 14-68 years) with Beh?et's disease and active ocular involvement that fulfilled the criteria of the International Study Group for Beh?et's Disease. In each patient, FFA and ICG angiography were performed consecutively in the same session using a TRC-50I/A fundus camera (Topcon, Tokyo, Japan) coupled to an Image Net digitizing system. All images were analyzed and FFA, ICG, and clinical findings summarized. RESULTS: The mean duration of ocular involvement was 52.4 months (range: 2-240 months). FFA showed staining and dye leakage at the optic disc in 44 (89.8%) eyes and diffuse vasculitis in 36 (73.5%) eyes. Macular edema and ischemia were observed in 31 (63.3%) and 3 (6.1%) eyes, respectively. Eight (16.3%) eyes exhibited detectable retinal FFA alterations, but no abnormalities on ICG angiography. Disc ICG hyperfluorescence was observed in 23 (46.9%) eyes. ICG angiography revealed choroidal fuzziness in 16 (32.6%) eyes, hyperfluorescent spots in 13 (26.5%) eyes, and hypofluorescent plaques in 12 (24.5%) eyes. Eleven eyes (22.4%) showed no abnormal findings on ICG angiography. CONCLUSION: ICG and FFA complement each other as tools for diagnosing patients with Beh?et's disease. FFA often serves as a fairly reliable guide. Although some ICG findings cannot be demonstrated by FFA, they are not specific or pathognomonic. We do not recommend performing both procedures for Beh?et's disease.