Scheider A, Voeth A, Kaboth A, Neuhauser L
Universitäts-Augenklinik, München, Federal Republic of Germany.
Ger J Ophthalmol. 1992;1(1):7-11.
Indocyanine green angiography with scanning laser ophthalmoscopy is a new supplementary method studying subretinal neovascular membranes. However, it is still controversial as to whether of not exudation of this dye occurs from regular choroidal vessels or such membranes. Fluorescence of the macula area, a parapapillary retinal vein, and of venous blood and plasma was therefore measured with a picture analysis system in five healthy young volunteers. Furthermore, the angiograms of 150 subretinal neovascular membranes were reviewed. Membrane fluorescence was measured in ten exemplary cases and compared with the background fluorescence. The results show that macula fluorescence is detectable much longer than the fluorescence of retinal vessels. However, a comparison with the fluorescence of blood and plasma samples revealed that this late fluorescence must be caused by retinal and choroidal capillaries with a significantly reduced hematocrit. It is not caused by apposition or exudation of indocyanine green. The same was true for the majority of subretinal neovascular membranes. Exudation was rarely detected in membranes that were regularly surrounded by exudates but could be induced by laser coagulation. These observations indicate that exudation occurs only after massive destruction of the endothelial barrier. The results are important for the interpretation of indocyanine green angiograms and for possible photodynamic therapy with this dye.
扫描激光眼底镜吲哚菁绿血管造影术是研究视网膜下新生血管膜的一种新的辅助方法。然而，关于这种染料是否从正常脉络膜血管或此类膜中渗出仍存在争议。因此，我们用图像分析系统对5名健康年轻志愿者的黄斑区、视乳头旁视网膜静脉以及静脉血和血浆的荧光进行了测量。此外，我们还回顾了150例视网膜下新生血管膜的血管造影片。在10例典型病例中测量了膜的荧光，并与背景荧光进行了比较。结果表明，黄斑荧光的可检测时间比视网膜血管的荧光长得多。然而，与血液和血浆样本的荧光比较显示，这种晚期荧光一定是由血细胞比容显著降低的视网膜和脉络膜毛细血管引起的。它不是由吲哚菁绿的附着或渗出引起的。大多数视网膜下新生血管膜也是如此。在经常被渗出物包围的膜中很少检测到渗出，但激光凝固可诱发渗出。这些观察结果表明，渗出仅在血管内皮屏障大量破坏后才会发生。这些结果对于解释吲哚菁绿血管造影片以及使用这种染料进行可能的光动力治疗具有重要意义。
