目的:观察多发性后极部色素上皮病变(multifocalposterior pigment epitheliopathy,MPPE)的荧光素眼底血管造影(fundus fluorescein angiography,FFA)和吲哚青绿眼底血管造影(indocyanine green angiography,ICGA)特征及其临床意义。方法:回顾性分析2007-01/2009-04期间在我院就诊的35例51眼MPPE患者的临床资料。所有患者都接受了常规视力、裂隙灯、直/间接眼底镜检查,同时行眼底彩色照相和德国海德堡共焦激光视网膜仪(HRA-2)的同步FFA和ICGA检查。结果:多灶性视网膜色素上皮(RPE)渗漏和脉络膜血管循环障碍(包括脉络膜血管充盈延迟以及脉络膜血管的扩张渗漏)是活动期MPPE患者在FFA和ICGA检查中的主要特征性改变。由于长期大量的RPE渗漏,部分患者会继发渗出性视网膜脱离,其中小部分在FFA检查中还有视网膜小血管普遍渗漏、视网膜无灌注区及新生血管形成、晚期视盘强荧光着色等慢性葡萄膜炎的改变。静止期MPPE患者在FFA和ICGA中的荧光改变则主要为RPE和脉络膜毛细血管的萎缩,而脉络膜血管充盈迟缓和血管扩张等循环异常变化基本消失。结论:MPPE有类似CSC的FFA和ICGA改变,但程度更重;其中部分患者还可伴有类似慢性葡萄膜炎的改变。MPPE的ICGA后期像中的暗黑色低红外荧光灶有助于我们判断患者病情的预后。

·AIM:To observe the features and the clinical significance of fundus fluorescein angiography(FFA)and indocyanine green angiography(ICGA)in multifocal posterior pigment epitheliopathy(MPPE).·METHODS:The clinical data of 35 cases(51 eyes)with MPPE during Jan.2007 to Apr.2009 were analyzed retrospectively.All the patients received the conventional examination,including the vision,slit-lamp,the direct/indirect ophthalmoscope examination,and the fundus color photography,FFA and ICGA with heidelberg retinal confocal laser instrument(HRA-2)were also carried out.·RESULTS:The multifocal retinal pigment epithelial(RPE)leakage and choroidal circulatory disturbances(including choroidal vascular filling delay as well as the expansion/leakage of choroidal blood vessels)were the main features of the MPPE in active phase examined by FFA and ICGA.Some patients occured the exudative retinal detachment for a large number of RPE leakage and a long time leakage,in which some changes similar to chronic uveitis appeared in a small part of patients including the leakages of retinal vessels,retinal non-perfusion areas and neovascularization,the disc with strong fluorescence in the FFA later phase.The chief changes were the RPE and choriocapillaris atrophy in FFA and ICGA with the MPPE in quiescent phase,but the choroidal circulation anomalies disappeared including the choroidal filling delay and dilated.·CONCLUSION:The MPPE patients have similar changes with central serous chorioretinopathy(CSC)in FFA and ICGA,but the degree is more serious,in which some patients can be accompanied with some similar changes with chronic uveitis.The black infrared fluorescent focus in ICGA during the late phase will help us to judge the prognosis of the MPPE.·

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