Scheider A, Neuhauser L
Augenklinik Ludwig-Maximilians-Universität, München, Federal Republic of Germany.
Ger J Ophthalmol. 1992;1(5):328-34.
The fluorescence of drusen and their correlation with choroidal perfusion was investigated using indocyanine-green videoangiography in 37 patients (mean age, 66 +/- 16 years) with juvenile and senile drusen. Most senile drusen (89%) blocked choroidal indocyanine-green fluorescence, and only three patients had small, weakly hyperfluorescent drusen at the vascular arcade. In contrast, all juvenile drusen (patients aged 31-52 years) demonstrated strong hyperfluorescence. Impaired choroidal perfusion was not detected. In 33% of the patients, all of them older than 60 years, moderate choroidal hypofluorescence could be explained by the presence of confluent drusen and/or a thickening of the pigment epithelium-Bruch's membrane complex. The results of the present study demonstrate that indocyanine-green angiography enables the differentiation of juvenile drusen from senile drusen, which could be an indication of a differing pathogenesis for the two diseases. Indocyanine-green hyperfluorescence of drusen must be caused by the transmission of choroidal fluoresence. This jeopardizes the hypothesis that the fluorescein fluorescence of drusen is invariably caused by storage of the dye. Our results contradict previous fluorescein studies that have demonstrated impaired choroidal perfusion in patients with age-related macular degeneration.
利用吲哚青绿视频血管造影术，对37例患有青少年性和老年性玻璃膜疣的患者（平均年龄66±16岁）进行了玻璃膜疣荧光及其与脉络膜灌注相关性的研究。大多数老年性玻璃膜疣（89%）遮挡脉络膜吲哚青绿荧光，仅3例患者在血管弓处有小的、弱高荧光的玻璃膜疣。相比之下，所有青少年性玻璃膜疣（年龄31 - 52岁的患者）均表现为强高荧光。未检测到脉络膜灌注受损。在33%的患者中，所有患者年龄均大于60岁，中度脉络膜低荧光可由融合性玻璃膜疣和/或色素上皮 - 布鲁赫膜复合体增厚来解释。本研究结果表明，吲哚青绿血管造影术能够区分青少年性玻璃膜疣和老年性玻璃膜疣，这可能表明这两种疾病的发病机制不同。玻璃膜疣的吲哚青绿高荧光必定是由脉络膜荧光的透射引起的。这对玻璃膜疣的荧光素荧光总是由染料储存引起的假说提出了质疑。我们的结果与先前关于年龄相关性黄斑变性患者脉络膜灌注受损的荧光素研究结果相矛盾。
