Howe L J, Woon H, Graham E M, Fitzke F, Bhandari A, Marshall J
Department of Ophthalmology, United Medical School, St. Thomas' Hospital, London, England.
Ophthalmology. 1995 May;102(5):790-8. doi: 10.1016/s0161-6420(95)30955-4.
The pathogenesis of acute posterior multifocal placoid pigment epitheliopathy remains obscure. The placoid lesions and characteristic findings on fluorescein angiography have been interpreted as representing either primary disease of the retinal pigment epithelium or disease of the choroidal vasculature. This study used indocyanine green (ICG) choroidal videoangiography to investigate this controversy.
Sequential choroidal videoangiography was performed with ICG and a scanning laser ophthalmoscope on patients with acute posterior multifocal placoid pigment epitheliopathy. Image analysis was used to differentiate between masking and ischemia as to the cause of hypofluorescence on the angiograms.
Indocyanine green angiograms of acute posterior multifocal placoid pigment epitheliopathy showed areas of hypofluorescence in both the early and late pictures that correlated with the placoid lesions. Image analysis identified these as areas of choroidal hypoperfusion. Successive films showed partial or complete resolution of these hypofluorescent areas.
Indocyanine green choroidal videoangiography has shown choroidal hypoperfusion to underlie the pathogenesis of acute posterior multifocal placoid pigment epitheliopathy.
急性后极部多灶性鳞状色素上皮病变的发病机制仍不清楚。鳞状病变及荧光素血管造影的特征性表现被解释为代表视网膜色素上皮的原发性疾病或脉络膜血管疾病。本研究使用吲哚菁绿（ICG）脉络膜视频血管造影来研究这一争议。
对急性后极部多灶性鳞状色素上皮病变患者使用ICG和扫描激光检眼镜进行连续脉络膜视频血管造影。图像分析用于区分血管造影上低荧光的原因是遮盖还是缺血。
急性后极部多灶性鳞状色素上皮病变的吲哚菁绿血管造影显示，早期和晚期图像中均有与鳞状病变相关的低荧光区域。图像分析将这些区域确定为脉络膜灌注不足区域。连续的图像显示这些低荧光区域部分或完全消退。
吲哚菁绿脉络膜视频血管造影显示脉络膜灌注不足是急性后极部多灶性鳞状色素上皮病变发病机制的基础。
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