藉循血綠眼底血管攝影及掃描雷射眼底鏡來偵側境界不明的脈絡膜新生血管

Detection of Occult Choroidal Neovascularization with Indocyanine Green Angiography and Scanning Laser Ophthalmoscope

楊昌叔(Chang-Sue Yang) ； 李鳳利(Fenq-Lih Lee) ； 林嘉理(Chia-Lee Lin) ； 蔡三章(San-Chang Tsai) ； 劉榮宏(Jorn-Hon Liu)

《中華民國眼科醫學會雜誌》 34卷2期 (1995/06) Pp. 135-142

https://doi.org/10.30048/ACTASOS.199506.0001

摘要

背景：螢光眼底血管攝影(fluorescein angiography (FA))是診斷老年性黃斑部變性的重要技術，然而它在脈絡膜新生血管(choroidal neovascularization (CNV))的偵測與精確定位上有其限制。本篇研究的目的，是籍循血綠眼底血管攝影(indocyanine green (ICG) angiography)來偵測境界不明(ill-defined or occult)的脈絡膜新生血管，其可能效益及將來臨床應用。
方法：共收集250眼，滲出型老年性黃斑部變性病例，探用掃瞄雷射眼底鏡(scanning laser ophthalmoscope (SLO))來實行循血綠眼底血管攝影；每一病眼皆先做螢光眼底血管攝影，以資比較兩者在偵測脈絡膜新生血管的能力。
結果：與螢光眼底血管攝影比較，循血綠眼底血管攝影在偵測境界不明的脈絡新生血管上，提供更佳的影像解析度。在螢光攝影為境界不明的新生血管192眼中，再做循血綠攝影，其中有88眼(46%)可轉變為境界分明的新生血管。
結論：循血綠眼底血管攝影是一項有效的輔助眼底造影技術，它在老年性黃斑部變性的境界不明新生血管的偵測上相當有幫助。尤其對脈絡膜新生血管的偵測上相當有幫助。而且對脈絡膜新生血管伴有視網膜色素上皮層剝離，及新生血管伴有視網膜出血的偵測上特別有用。我們建議，若傳統螢光血管攝影為境界不明新生血管時，應再做循血綠眼底血管攝影。

並列摘要

Background. Fluorescein angiography (FA) is important in the diagnosis of choroidal neovascularization (CNV), however, there are some limitations to this technique. We conducted this study to evaluate the efficacy of indocyanine green (ICG) angiography in the detection of ill-defined or occult choroidal neovascularization.
Methods. The authors performed ICG angiography with scanning laser ophthalmoscope (SLO) in 250 eyes with exudative age-related macular degeneration (ARMD). To compare ICG angiography with FA, we performed both in each of our cases to evaluate the ability of detecting CNV.
Results. ICG angiography provided enhanced image resolution of occult CNV compared with FA. In the subgroup of 192 eyes with occult CNV proved by FA, 88 eyes (46%) could be reclassified as well- defined CNV based on the information provided by ICG angiography.
Conclusion. ICG angiography is a useful adjunctive technique to fluorescein angiography for the detection of choroidal neovascularization secondary to ARMD. ICG angiography increased the detection and delineation of occult CNV, it was especially useful in eyes of CNV with retinal pigment epithelial detachment, and CNV with overlying hemorrhage. The authors suggested ICG angiography should be performed in eyes which ill-defined CNV can't be identified by FA. The goal of future study is to evaluate whether ICG-guided laser photocoagulation would be beneficial in the treatment of occult CNV in ARMD.

並列關鍵字

Fluorescein angiography ； Indocyanine Green Angiography ； occult Choroidal Neovasculization ； Scanning Laser ophthalmoscope