Arnold J J, Quaranta M, Soubrane G, Sarks S H, Coscas G
Clinique Ophtalmologique Universitaire de Créteil, France.
Am J Ophthalmol. 1997 Sep;124(3):344-56. doi: 10.1016/s0002-9394(14)70826-8.
To analyze the indocyanine green angiographic findings of drusen in the early stages of age-related macular degeneration.
Sixty-nine eyes of 53 consecutive patients with drusen but without exudative complications of age-related macular degeneration were studied. Drusen were classified into four groups: hard drusen, drusen derived from clusters of hard drusen (hard cluster-derived drusen and soft cluster-derived drusen), membranous drusen, and regressing drusen. An additional category was constituted by reticular pseudodrusen that could be associated with drusen of either the inner or outer macula. Results of contact lens biomicroscopy and fluorescein angiography were compared with findings on indocyanine green angiography.
Hard drusen, either isolated hard drusen or hard cluster-derived drusen, were hyperfluorescent during indocyanine green angiography; in contrast, all sizes of soft drusen derived from clusters of hard drusen were hypofluorescent throughout the angiogram. Membranous drusen, visible on biomicroscopy and fluorescein angiography, were not visible during indocyanine green angiography. Regressing drusen may have showed hyperfluorescence at the early stages of indocyanine green angiography, but associated calcium and pigmentation were hypofluorescent. Reticular pseudodrusen were visible on red-free photographs; on midphase and late-phase indocyanine green angiography using the scanning laser ophthalmoscope only, reticular pseudodrusen were seen as a pattern of hypofluorescent dots.
The indocyanine green angiographic findings add to and support the clinicopathologic classification of drusen. Indocyanine green angiography may help to distinguish the different types of drusen and may thus be of use in evaluating the risk of progressive age-related macular degeneration in patients with drusen.
分析年龄相关性黄斑变性早期玻璃膜疣的吲哚青绿血管造影表现。
对53例连续患者的69只眼进行研究，这些患者有玻璃膜疣但无年龄相关性黄斑变性的渗出性并发症。玻璃膜疣分为四组：硬性玻璃膜疣、由硬性玻璃膜疣簇衍生的玻璃膜疣（硬性簇衍生玻璃膜疣和软性簇衍生玻璃膜疣）、膜性玻璃膜疣和消退性玻璃膜疣。另外，网状假性玻璃膜疣单独归为一类，其可能与黄斑内层或外层的玻璃膜疣相关。将接触镜生物显微镜检查和荧光素血管造影结果与吲哚青绿血管造影结果进行比较。
硬性玻璃膜疣，无论是孤立的硬性玻璃膜疣还是硬性簇衍生玻璃膜疣，在吲哚青绿血管造影期间均表现为高荧光；相反，所有大小的由硬性玻璃膜疣簇衍生而来的软性玻璃膜疣在整个血管造影过程中均表现为低荧光。膜性玻璃膜疣在生物显微镜检查和荧光素血管造影中可见，但在吲哚青绿血管造影中不可见。消退性玻璃膜疣在吲哚青绿血管造影早期可能表现为高荧光，但相关的钙和色素沉着为低荧光。网状假性玻璃膜疣在无赤光照片上可见；仅在使用扫描激光检眼镜进行的中期和晚期吲哚青绿血管造影中，网状假性玻璃膜疣表现为低荧光点的形态。
吲哚青绿血管造影表现补充并支持了玻璃膜疣的临床病理分类。吲哚青绿血管造影可能有助于区分不同类型的玻璃膜疣，因此可用于评估有玻璃膜疣患者发生年龄相关性黄斑变性进展的风险。
