Isomae T, Shimada H, Nakajima M, Yuzawa M
Department of Ophthalmology, Surugadai Hospital, Nihon University, Tokyo, Japan.
Jpn J Ophthalmol. 2000 Mar;44(2):190. doi: 10.1016/s0021-5155(99)00208-7.
Purpose: To review the outcome of surgical removal of choroidal neovascular membranes in age-related macular degeneration as classified by indocyanine green angiographic findings.Subjects and Method: Surgery was performed in 42 eyes. They were divided into four types by indocyanine green angiographic findings prior to surgery. Type I comprised 29 eyes showing hyperfluorescence throughout the angiographic phases. Type II comprised 3 eyes showing hyperfluorescence during the early phase only. Type III comprised 5 eyes showing hyperfluorescence in the late phase only. Type IV comprised 5 eyes without hyperfluorescence throughout the angiographic phases. The results were evaluated according to the visual acuity expressed as log MAR before and after surgery.Results: Visual acuity improved significantly in Types I, II, and III after surgery. Visual acuity did not improve in Type IV.Conclusion: The findings of indocyanine green angiography are thought to reflect the histological characteristics of the choroidal neovascular membrane. Neovascular membranes of Type IV may contain a smaller number of vessels and abundant fibrous tissue. Eyes of Type IV will have atrophies in the neurosensory retina, retinal pigment epithelium, and choriocapillaris. Surgical removal of the choroidal neovascular membrane in Type IV is not effective in improving visual acuity.
根据吲哚菁绿血管造影结果,回顾年龄相关性黄斑变性患者脉络膜新生血管膜手术切除的效果。
对42只眼进行手术。术前根据吲哚菁绿血管造影结果将其分为四种类型。I型包括29只眼,在整个血管造影阶段均显示高荧光。II型包括3只眼,仅在早期显示高荧光。III型包括5只眼,仅在晚期显示高荧光。IV型包括5只眼,在整个血管造影阶段均无高荧光。根据手术前后以log MAR表示的视力评估结果。
I型、II型和III型术后视力显著提高。IV型视力未提高。
吲哚菁绿血管造影结果被认为反映了脉络膜新生血管膜的组织学特征。IV型新生血管膜可能含有较少的血管和丰富的纤维组织。IV型眼的神经感觉视网膜、视网膜色素上皮和脉络膜毛细血管会出现萎缩。IV型脉络膜新生血管膜的手术切除对提高视力无效。