Dyer D S, Brant A M, Schachat A P, Bressler S B, Bressler N M
Retinal Vascular Center, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine and Hospital, Baltimore, Maryland, USA.
Am J Ophthalmol. 1995 Oct;120(4):497-505. doi: 10.1016/s0002-9394(14)72664-9.
We sought to identify specific fluorescein angiographic patterns that may have led to the diagnosis of questionable recurrent choroidal neovascularization. We evaluated follow-up information to determine whether any specific angiographic patterns could be used to identify patients at high risk for definite recurrence.
We identified fluorescein angiograms graded as questionable for recurrent choroidal neovascularization that were taken from a previous prospective study involving 401 consecutive follow-up visits of patients treated with photocoagulation for choroidal neovascularization. We reviewed these angiograms to identify specific angiographic patterns that might have led to the classification of questionable recurrent choroidal neovascularization. Angiograms from visits subsequent to a questionable recurrence were reviewed to determine which patterns, if any, were associated with an increased risk for a definite recurrence to develop later.
Forty-four eyes (44 patients) with questionable recurrences (of which 40 had at least four months of follow-up) were categorized into six angiographic patterns. The three most common patterns included the following: (1) focal staining along the edge of the laser lesion (20 cases, 15 subsequently recurred); (2) blocked fluorescence from subretinal hemorrhage not documented at the previous visit (eight cases, five subsequently recurred); (3) speckled hyperfluorescence noted beyond the edge of the laser lesion (eight cases, six subsequently recurred).
Questionable recurrent choroidal neovascularization may be identified by specific angiographic patterns. Focal staining along the edge of the laser lesion and speckled hyperfluorescence were the patterns that were most likely to progress to definite recurrence.
我们试图识别可能导致可疑复发性脉络膜新生血管诊断的特定荧光素血管造影模式。我们评估随访信息，以确定是否有任何特定的血管造影模式可用于识别有明确复发高风险的患者。
我们从一项先前的前瞻性研究中识别出被评为可疑复发性脉络膜新生血管的荧光素血管造影片，该研究涉及401例接受脉络膜新生血管光凝治疗患者的连续随访。我们复查这些血管造影片，以识别可能导致可疑复发性脉络膜新生血管分类的特定血管造影模式。复查可疑复发后随访的血管造影片，以确定哪些模式（如果有的话）与随后发生明确复发的风险增加相关。
44只眼（44例患者）有可疑复发（其中40例至少随访4个月），被分为六种血管造影模式。三种最常见的模式如下：（1）激光损伤边缘的局灶性染色（20例，15例随后复发）；（2）上次随访未记录的视网膜下出血导致的荧光遮挡（8例，5例随后复发）；（3）激光损伤边缘以外的斑点状高荧光（8例，6例随后复发）。
可疑复发性脉络膜新生血管可通过特定的血管造影模式识别。激光损伤边缘的局灶性染色和斑点状高荧光是最有可能进展为明确复发的模式。
