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使用荧光素和吲哚菁绿血管造影术比较结节病相关性脉络膜视网膜炎中视网膜和脉络膜受累情况

Comparison of Retinal and Choroidal Involvement in Sarcoidosis-related Chorioretinitis Using Fluorescein and Indocyanine Green Angiography.

作者信息

El Ameen Ala'a, Herbort Carl P

机构信息

Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialised Care, Teaching Centre Clinic Montchoisi, Lausanne, Switzerland.

Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland.

出版信息

J Ophthalmic Vis Res. 2018 Oct-Dec;13(4):426-432. doi: 10.4103/jovr.jovr_201_17.

Abstract

PURPOSE

To compare the involvement of the retina with that of the choroid in ocular sarcoidosis (OS) using dual fluorescein angiography (FA)/indocyanine green angiography (ICGA).

METHODS

A retrospective study of 23 patients with the diagnosis of OS was performed. Angiographic signs were quantified following the established FA/ICGA scoring system for uveitis.

RESULTS

The choroid was predominantly involved in 19 (82.6%) patients or 87% (40/46) of the eyes, and the retina in 2 (8.7%) patients or 13% (6/46) of the eyes. The mean angiographic score was 7.15 ± 4.5 for the retina (FA) compared to 14.02 ± 4.86 for the choroid (ICGA) ( < 0.0001). In 13% (3/23) of patients, FA did not show retinal inflammation, whereas ICGA was strongly positive, revealing occult choroidal lesions.

CONCLUSION

The choroid is preferentially involved in OS, for which ICGA is the examination of choice. There is a risk of underestimating the global ocular involvement and of missing choroidal involvement if only FA is used. FA/ICGA scoring system allows for quantitative assessment of inflammation in the posterior uvea that occurs in OS; therefore, the system can be useful to quantitatively monitor outcomes in clinical trials.

摘要

目的

使用双荧光素血管造影(FA)/吲哚菁绿血管造影(ICGA)比较眼部结节病(OS)中视网膜与脉络膜受累情况。

方法

对23例诊断为OS的患者进行回顾性研究。按照既定的葡萄膜炎FA/ICGA评分系统对血管造影征象进行量化。

结果

脉络膜受累为主的患者有19例(82.6%),占所有眼睛的87%(40/46);视网膜受累为主的患者有2例(8.7%),占所有眼睛的13%(6/46)。视网膜(FA)的平均血管造影评分为7.15±4.5,而脉络膜(ICGA)为14.02±4.86(P<0.0001)。13%(3/23)的患者FA未显示视网膜炎症,而ICGA呈强阳性,揭示了隐匿性脉络膜病变。

结论

脉络膜在OS中更易受累,ICGA是首选检查方法。若仅使用FA,存在低估整体眼部受累情况及漏诊脉络膜受累的风险。FA/ICGA评分系统可对OS中后葡萄膜的炎症进行定量评估;因此,该系统有助于在临床试验中对结果进行定量监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0be3/6210872/50ce08f5726a/JOVR-13-426-g001.jpg

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