Yan Hong, Yi Changxian, Wen Feng, Hu Zhaoke, Hu Shixing, Liu Shunying, Mai Guiying, Huang Xintao
Zhongshan Opthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.
Yan Ke Xue Bao. 2002 Jun;18(2):80-3.
To study the angiographic changes in the optic disc and its surrounding choroidoretina after optic nerve contusion with fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA).
Thirty patients (30 eyes) with various degree of optic nerve damage caused by ocular contusion were examined with FFA and ICGA. (The choroidal rupture were excluded in this study).
All patients present some abnormal angiography except one case. The main findings in FFA were hypofluorescein on quadrantal or entire disc in the early phase and leakage or persistent nonperfusion in the late phase. Meanwhile, the choroid surrounding disc was clearly delayed in its choroidal filling time. The retinal pigment epithelium (RPE) damage was observed over the localized abnormally perfused choroid. However, the RPE above the circular area around the disc which was hypofluorescein in ICGA showed no RPE damage in 9 cases. There are 2 cases combined with branche retinal vein occlusion and 19 (63%) cases showed ischemic changes exactly on the location of so-called "water separating zone". The visual acuity was not more than 0.1 in 80% of the patients in this study.
There is severe optic nerve lesion in the strong ocular contusion, in which the choroidal and retinal arterial circulation has also been seriously damaged. The FFA and ICGA should be conducted in time in order to judge the injury correctly and allow the clinician to better manage the cases.
通过眼底荧光血管造影(FFA)和吲哚菁绿血管造影(ICGA)研究视神经挫伤后视盘及其周围脉络膜视网膜的血管造影变化。
对30例(30只眼)因眼挫伤导致不同程度视神经损伤的患者进行FFA和ICGA检查。(本研究排除脉络膜破裂患者)。
除1例患者外,所有患者均出现一些血管造影异常。FFA的主要表现为早期象限性或整个视盘低荧光,晚期渗漏或持续无灌注。同时,视盘周围脉络膜的脉络膜充盈时间明显延迟。在局部异常灌注的脉络膜上方观察到视网膜色素上皮(RPE)损伤。然而,在ICGA中视盘周围圆形区域低荧光上方的RPE在9例患者中未显示RPE损伤。有2例合并视网膜分支静脉阻塞,19例(63%)在所谓“水分离区”位置出现缺血改变。本研究中80%的患者视力不超过0.1。
重度眼挫伤存在严重的视神经损伤,其中脉络膜和视网膜动脉循环也受到严重损害。应及时进行FFA和ICGA检查,以便正确判断损伤情况,让临床医生更好地处理病例。