Mueller A J, Bartsch D U, Schaller U, Freeman W R, Kampik A
Augenklinik der Universität, München, Germany.
Int Ophthalmol. 2001;23(4-6):385-93. doi: 10.1023/a:1014471118208.
Histologically demonstrable microcirculation patterns (microcirculation pattern) of human choroidal melanomas have prognostic significance for the patient. We report on our experience in imaging these microcirculation pattern in vivo using simultaneous confocal Fluorescein (FA)- and Indocyaninegreen (ICG) angiography before and after brachytherapy.
The simultaneously procured confocal FA- and ICG angiograms of 50 patients with untreated choroidal melanomas were studied for the visibility of microcirculation pattern. Patients were also followed with simultaneous FA/ICG after brachytherapy.
Confocal FA disclosed signs of tumor vascularization in 12 (24%) of the 50 examined patients but microcirculation pattern only in 3 patients (6%). In contrast, simultaneously obtained confocal ICG disclosed microcirculation pattern in 47 patients (94%). In 10 (77%) of the 13 patients the tumor microcirculation changed considerably after brachytherapy: Distortion, thickening, thinning, as well as complete obliteration of vessels could be observed.
Histologically demonstrated microcirculation pattern can be imaged in vivo. This offers the possibility to assess the likely biologic behavior of the individual tumor without the need for obtaining a cytologic or histologic specimen via enucleation or fine-needle biopsy. Confocal ICG angiogiography images microcirculation pattern better than FA which can be explained by the different absorption-, fluorescence- and exudation-characteristics ICG. Follow-up with confocal ICG of choroidal melanomas after brachytherapy shows different features and allows for visualization of the microcirculation reaction to the treatment which might be a useful tool for studying the effects of future anti-angiogenesis based tumor therapies.
人类脉络膜黑色素瘤组织学上可证实的微循环模式对患者具有预后意义。我们报告了在近距离放疗前后使用同步共聚焦荧光素（FA）和吲哚菁绿（ICG）血管造影对这些微循环模式进行体内成像的经验。
研究了50例未经治疗的脉络膜黑色素瘤患者同步采集的共聚焦FA和ICG血管造影，以观察微循环模式的可见性。患者在近距离放疗后也接受了同步FA/ICG随访。
共聚焦FA在50例受检患者中的12例（24%）显示出肿瘤血管化迹象，但仅在3例患者（6%）中显示出微循环模式。相比之下，同步获得的共聚焦ICG在47例患者（94%）中显示出微循环模式。在13例患者中的10例（77%）中，近距离放疗后肿瘤微循环发生了显著变化：可观察到血管扭曲、增粗、变细以及完全闭塞。
组织学上证实的微循环模式可以在体内成像。这提供了在无需通过眼球摘除或细针活检获取细胞学或组织学标本的情况下评估个体肿瘤可能生物学行为的可能性。共聚焦ICG血管造影对微循环模式的成像优于FA，这可以用ICG不同的吸收、荧光和渗出特性来解释。脉络膜黑色素瘤近距离放疗后用共聚焦ICG进行随访显示出不同特征，并允许可视化对治疗的微循环反应，这可能是研究未来基于抗血管生成的肿瘤治疗效果的有用工具。
