Giovannini A, Scassellati-Sforzolini B, Mariotti C, D'Altobrando E
Department of Ophthalmology, University of Ancona, Italy.
Int Ophthalmol. 1996;20(4):171-9. doi: 10.1007/BF00175256.
Evaluation of choroidal alterations associated with idiopathic choroidal neovascularization (ICNV) and the possible relation between this affection and Multifocal Choroidopathies (MC).
The authors analysed, using high definition videoangiography, the choroidal findings in 21 consecutive patients affected by ICNV (7 males and 14 females; 19-46 years; mean age: 31.8 years); with a follow-up at 5-30 months (mean 13 months). Moreover, a retrospective study of 20 cases of ICNV (11 males and 9 females; age: 17-39 years; mean age: 29.3 years) with a follow-up at 6-11 years (mean 8.9), was performed.
In 7 eyes, the indocyanine green angiography (ICGA) showed choroidal hypofluorescent spots similar to those observed in MC (in 3 cases even in the fellow unaffected eye), in 2 of them the regression of the spots was observed after steroid therapy. In 2 eyes, the ICGA revealed hyperfluorescent spots; in one of them the complete regression of the spots after oral cyprofloxacine was observed. In 6 patients (10 eyes), choroidal permeability alterations could be visualized (in 4 cases even in the unaffected eye).
The indocyanine green angiographic findings (hypo and hyperfluorescent spots, choroidal permeability alterations) could support the theory of Gass which considers that ICNV is not idiopathic but secondary to a widespread choroidal inflammatory disease. The similarity of the ICGA alterations in ICNV and MC, the observation that cases of ICNV would become MC in the follow-up, could allow the hypothesis of a close connection between these two affections.
评估与特发性脉络膜新生血管(ICNV)相关的脉络膜改变,以及这种病变与多灶性脉络膜病变(MC)之间的可能关系。
作者使用高清视频血管造影术分析了21例连续的ICNV患者(7例男性和14例女性;年龄19 - 46岁;平均年龄:31.8岁)的脉络膜表现;随访时间为5 - 30个月(平均13个月)。此外,对20例ICNV患者(11例男性和9例女性;年龄:17 - 39岁;平均年龄:29.3岁)进行了回顾性研究,随访时间为6 - 11年(平均8.9年)。
在7只眼中,吲哚菁绿血管造影(ICGA)显示脉络膜低荧光斑,类似于在MC中观察到的情况(3例中甚至在未受影响的对侧眼中也有),其中2例在类固醇治疗后观察到斑点消退。在2只眼中,ICGA显示高荧光斑;其中1只在口服环丙沙星后斑点完全消退。在6例患者(10只眼)中,可以观察到脉络膜通透性改变(4例中甚至在未受影响的眼中也有)。
吲哚菁绿血管造影结果(低荧光和高荧光斑、脉络膜通透性改变)可能支持Gass的理论,该理论认为ICNV并非特发性,而是继发于广泛的脉络膜炎症性疾病。ICNV和MC中ICGA改变的相似性,以及ICNV病例在随访中会发展为MC的观察结果,可能支持这两种病变之间存在密切联系的假设。