Giovannini A, Scassellati Sforzolini B, D'altobrando E, Mariotti C
Clinica Oculistica dell'Università di Ancona, Nuovo Ospedale Regionale di Torrette, Italy.
Bull Soc Belge Ophtalmol. 1996;263:115-21; discussion 122.
With high definition videoangiography (TOPCON IMAGEnet H1024) the Authors studied 41 patients affected by multifocal choroidopathies (MC) (68 eyes with ophthalmoscopic or indocyanine green angiographic evidences): 29 females and 12 males; age 21-51 years with a follow up of 6-29 months. In the light of the evidence provided by FA and ICG the Authors present a classification of MC in three stages: Stage 1 of subclinical choroidal activity (5 eyes): characterised by the presence of hypofluorescent or hyperfluorescent spots visible only in the late phases of ICGA; stage 2 of clinically evident choroidal activity (45 eyes): in FA the spots are hypofluorescent in the early phases and hyperfluorescent with a slight diffusion in the late phases, in ICGA either hypofluorescent spots or less frequently hyperfluorescent spots and choroidal permeability alterations can be observed; stage 3 or healed stage (18 eyes): in FA the spots are hyperfluorescent without late leakage, in ICGA hypofluorescence can be observed during all angiographic phases. In 5 patients in stage 1 of subclinical activity, a systemic steroid therapy induced the regression of the hypofluorescent sports in ICGA, in 2 cases the regression of hyperfluorescent spots in ICGA was observed after systemic antibiotic therapy. The authors underline that ICGA could be a particularly useful tool for an early diagnosis and clinical monitoring of MC.
作者使用高清视频血管造影术(拓普康IMAGEnet H1024)研究了41例多灶性脉络膜病变(MC)患者(68只眼有检眼镜或吲哚菁绿血管造影证据):女性29例,男性12例;年龄21 - 51岁,随访6 - 29个月。根据荧光素血管造影(FA)和吲哚菁绿血管造影(ICGA)提供的证据,作者将MC分为三个阶段:亚临床脉络膜活动期1期(5只眼):特征为仅在ICGA晚期可见的低荧光或高荧光斑点;临床明显脉络膜活动期2期(45只眼):在FA中,斑点在早期为低荧光,晚期为高荧光且有轻微扩散,在ICGA中可观察到低荧光斑点或较少见的高荧光斑点以及脉络膜通透性改变;3期或愈合期(18只眼):在FA中,斑点为高荧光且无晚期渗漏,在ICGA中,在所有血管造影阶段均可观察到低荧光。在5例亚临床活动期1期的患者中,全身类固醇治疗使ICGA中的低荧光病灶消退,2例患者在全身抗生素治疗后观察到ICGA中的高荧光斑点消退。作者强调,ICGA可能是MC早期诊断和临床监测的一种特别有用工具。