Gaudric Alain
Ophthalmology Department, Hopital Lariboisière, APHP, Université Paris Cité, Paris, France, and Centre d'Imagerie et Laser, Paris, France.
Ophthalmol Sci. 2023 Oct 3;4(2):100406. doi: 10.1016/j.xops.2023.100406. eCollection 2024 Mar-Apr.
The hypofluorescence of fundus lesions observed during the late phase of indocyanine green angiography (ICGA) in various diseases has often been overlooked or misinterpreted. This article explores the significance of fundus lesions that are initially isofluorescent during the early phase of ICGA but become hypofluorescent later in the examination.
Pathologies such as multiple evanescent white spot syndrome, acute posterior placoid syphilitic chorioretinitis, chronic central serous chorioretinopathy, choroidal hemangioma, and some fundus with drusen, present this phenomenon of late hypofluorescence.
The interpretation of ICGA images and the role of indocyanine green (ICG) uptake by the retinal pigment epithelium (RPE) in late fundus fluorescence is debated. Experimental evidence suggests that ICG accumulates progressively in the RPE after intravenous injection of the dye or after direct contact in vitro, making it a potential marker of RPE activity. Although the exact mechanisms of ICG diffusion through the choroid and its binding to the RPE require further investigation, the late hypofluorescence observed in certain ICGA diseases provides information on different modalities of RPE dysfunction.
The author has no proprietary or commercial interest in any materials discussed in this article.
在各种疾病的吲哚菁绿血管造影（ICGA）晚期观察到的眼底病变低荧光常常被忽视或误解。本文探讨了在ICGA早期最初表现为等荧光但在检查后期变为低荧光的眼底病变的意义。
多发性一过性白点综合征、急性后极部扁平部梅毒性脉络膜视网膜炎、慢性中心性浆液性脉络膜视网膜病变、脉络膜血管瘤以及一些有玻璃膜疣的眼底等病变呈现这种晚期低荧光现象。
关于ICGA图像的解读以及视网膜色素上皮（RPE）摄取吲哚菁绿（ICG）在晚期眼底荧光中的作用存在争议。实验证据表明，静脉注射染料后或体外直接接触后，ICG会在RPE中逐渐积累，使其成为RPE活性的潜在标志物。尽管ICG通过脉络膜扩散及其与RPE结合的确切机制需要进一步研究，但在某些ICGA疾病中观察到的晚期低荧光提供了有关RPE功能障碍不同形式的信息。
作者对本文讨论的任何材料均无专利或商业利益。
