Kuckelkorn R, Remky A, Wolf S, Reim M, Redbrake C
Department of Ophthalmology, Faculty of Medicine, Rheinisch-Westfälische Technische Hochschule, Aachen, Germany.
Acta Ophthalmol Scand. 1997 Dec;75(6):675-80. doi: 10.1111/j.1600-0420.1997.tb00629.x.
Severe eye burns often result in extensive necrosis of the conjunctiva and episcleral tissue. Video fluorescein angiography was performed to reveal the perfusion of the anterior eye segment after severe eye burns.
A scanning laser ophthalmoscope was used for anterior segment fluorescein angiography in 12 patients (14 eyes) with severe burns grade III-IV and in 7 healthy volunteers.
Necrotic tissues occurred as non perfused areas and remained dark throughout the whole angiogram. In general, the borders from healthy to necrotic conjunctival tissue were sharply demarcated. Thus, the extent of scleral and limbal ischemia could be determined exactly. Injured vessels showed hyperfluorescence with late leakage. Damage of the subconjunctival tissue appeared as a deep weak fluorescence in the early angiography and exhibited patchy leakage in the late angiogram.
Anterior segment angiography provides a basis for deciding the extent of surgical debridement of necrotic tissue in the acute phase of the burn. The determination of the extent of limbal and scleral ischemia may give useful information for early plastic-reconstructive procedures.
严重眼烧伤常导致结膜和巩膜前段组织广泛坏死。进行视频荧光血管造影以揭示严重眼烧伤后眼前段的灌注情况。
使用扫描激光检眼镜对12例(14只眼)III - IV级严重烧伤患者及7名健康志愿者进行前段荧光血管造影。
坏死组织表现为无灌注区,在整个血管造影过程中均保持黑暗。一般来说,从健康结膜组织到坏死结膜组织的边界清晰可辨。因此,可准确确定巩膜和角膜缘缺血的范围。受损血管表现为早期高荧光并伴有晚期渗漏。结膜下组织损伤在早期血管造影中表现为深层弱荧光,在晚期血管造影中表现为斑片状渗漏。
前段血管造影为烧伤急性期坏死组织手术清创范围的确定提供了依据。角膜缘和巩膜缺血范围的确定可为早期整形重建手术提供有用信息。