Gharbiya M, Pantaleoni F B, Grandinetti F, Gabrieli C B
Institute of Ophthalmology, University La Sapienza of Rome, Italy.
Eye (Lond). 1999 Oct;13 ( Pt 5):621-8. doi: 10.1038/eye.1999.170.
The authors report the cases of two patients affected with idiopathic choroidal neovascularisation studied with combined fluorescein angiography and indocyanine green (ICG) angiography. In particular the presence of choroidal abnormalities at ICG angiography which could not be detected by fluorescein angiography was studied.
Both patients underwent a complete systemic and ocular assessment. Fluorescein angiography and ICG angiography were performed in a routine fashion at the time of presentation in both cases and after 14 months in the second patient.
Results of the systemic investigations were unremarkable. A distinct dark rim surrounding the choroidal neovascular net was evident until the late phases of ICG angiography despite the presence of subretinal blood. Dilated choroidal vessels were observed beneath the neovascular membrane in both cases. In the first patient a hyperfluorescent area beyond the primary lesion was detected in the affected eye and a distinct leaking subfoveal choroidal venous vessel was found in the fellow eye. The second patient never showed other angiographic alterations either in the affected or in the fellow eye.
ICG angiography has proved to be useful, both to better define and follow up the true extent of the pigment halo (healing response) around the neovascular membrane when subretinal blood and dye leakage at fluorescein angiography prevent its full appreciation, and to rule out other causes of choroidal neovascularisation in young healthy adults associated with either choroidal inflammatory focal lesions or choroidal vascular dynamic or inflammatory alterations.
作者报告了两例患有特发性脉络膜新生血管的患者,对其进行了荧光素血管造影和吲哚菁绿(ICG)血管造影联合检查。特别研究了ICG血管造影中出现的而荧光素血管造影无法检测到的脉络膜异常情况。
两名患者均接受了全面的全身和眼部评估。两例患者在初诊时均常规进行了荧光素血管造影和ICG血管造影,第二例患者在14个月后再次进行了检查。
全身检查结果无异常。尽管存在视网膜下出血,但在ICG血管造影的晚期阶段,脉络膜新生血管网周围仍可见明显的深色边缘。两例患者的新生血管膜下方均观察到脉络膜血管扩张。在第一例患者中,患眼在原发性病变之外检测到一个高荧光区域,而对侧眼发现了一条明显渗漏的黄斑下脉络膜静脉血管。第二例患者的患眼和对侧眼均未出现其他血管造影改变。
ICG血管造影已被证明是有用的,当荧光素血管造影时的视网膜下出血和染料渗漏妨碍对色素晕(愈合反应)围绕新生血管膜的真实范围进行全面评估时,它有助于更好地界定和随访该范围,并且可以排除年轻健康成年人中与脉络膜炎性局灶性病变或脉络膜血管动力学或炎性改变相关的脉络膜新生血管形成的其他原因。