Wolfensberger T J, Herbort C P
Hôpital Ophtalmique Jules Gonin, Department of Ophthalmology, University of Lausanne, Switzerland.
Ophthalmology. 1999 Feb;106(2):285-9. doi: 10.1016/S0161-6420(99)90067-2.
To determine indocyanine green (ICG) angiographic features and evaluate the extent of choroidal involvement in proven cases of posterior ocular sarcoidosis.
Nonrandomized controlled trial.
Nineteen patients (14 females, 5 males; average age, 56 +/- 4 years) with clinically typical posterior sarcoidosis (biopsy-proven in 6 cases and fulfilling the other diagnostic criteria in 13 cases) participated, with 10 control subjects (average age, 48 +/- 7 years). Criteria for the diagnosis of sarcoidosis were a positive biopsy result or the presence of at least three of the following four criteria: elevated serum angiotensin-converting enzyme, elevated lysozyme, cutaneous anergy, and hilar lymph node enlargement.
Indocyanine green angiography was performed according to a standard angiographic protocol used in inflammatory disorders.
Indocyanine green angiographic features and proportion of choroidal inflammatory involvement were measured.
Indocyanine green angiographic features could be classified into four main patterns. The first pattern is hypofluorescent choroidal lesions in the early and intermediate phases, irregularly distributed, invisible on funduscopy or fluorescein angiography, and localized in the midperiphery (63% of patients), in the macula (11%) or in both regions (26%) with an average dot diameter of 0.31 +/- 0.03 disc diameters. These lesions either became isofluorescent in the late phase of the angiogram (Type 1, present in all patients) or remained hypofluorescent (Type 2, present in 84% of patients). The second pattern is focal hyperfluorescent pinpoints visible in the intermediate and late phases (in 89% of patients). The third pattern is fuzzy choroidal vessels with leakage in the intermediate phase of the angiogram, and the fourth pattern is diffuse late zonal choroidal hyperfluorescence with staining in the late phase of the angiogram, both features being present in all patients.
Indocyanine green angiography allowed the authors to assess and quantify the hitherto unknown extent of choroidal involvement in ocular sarcoidosis. Furthermore, characteristic ICG findings might represent an additional valuable tool for diagnosing and monitoring this disease.
确定吲哚菁绿（ICG）血管造影特征，并评估确诊的后葡萄膜炎结节病患者脉络膜受累的程度。
非随机对照试验。
19例患者（14例女性，5例男性；平均年龄56±4岁），患有临床典型的后葡萄膜炎结节病（6例经活检证实，13例符合其他诊断标准），另有10名对照者（平均年龄48±7岁）。结节病的诊断标准为活检结果阳性或具备以下四项标准中的至少三项：血清血管紧张素转换酶升高、溶菌酶升高、皮肤无反应性和肺门淋巴结肿大。
按照用于炎症性疾病的标准血管造影方案进行吲哚菁绿血管造影。
测量吲哚菁绿血管造影特征和脉络膜炎症受累比例。
吲哚菁绿血管造影特征可分为四种主要类型。第一种类型是早期和中期脉络膜低荧光病变，分布不规则，眼底镜检查或荧光素血管造影不可见，位于中周边部（63%的患者）、黄斑区（11%）或两个区域（26%），平均点状直径为0.31±0.03视盘直径。这些病变在血管造影后期要么变为等荧光（1型，所有患者均有），要么保持低荧光（2型，84%的患者有）。第二种类型是在中期和后期可见的局灶性高荧光小点（89%的患者有）。第三种类型是血管造影中期脉络膜血管模糊并渗漏，第四种类型是血管造影后期弥漫性带状脉络膜高荧光并伴有染色，这两种特征在所有患者中均有。
吲哚菁绿血管造影使作者能够评估和量化此前未知的葡萄膜炎结节病脉络膜受累程度。此外，特征性的吲哚菁绿检查结果可能是诊断和监测该疾病的另一种有价值的工具。
