ICGA对NAION与视神经炎的鉴别诊断作用
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Effect of ICGA in differential diagnosis between nonarteritic anterior ischemic optic neuropathy and optic neuritis
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    摘要:

    目的:初步探讨ICGA对非动脉炎性前部缺血型视神经病变与视神经炎鉴别诊断中的作用。 方法:临床资料完整的不易确诊视盘水肿患者27例27眼,经眼底照相后,采用视网膜血管和脉络膜血管双项造影检查。同期对年龄性别匹配20例20眼正常对照眼进行造影检查,对脉络膜血管造影的连续图像进行分析和总结。 结果:对照眼20例ICGA检查结果显示早期视盘周围脉络膜血管区荧光充盈正常。27眼视盘水肿者接受ICGA检查后,从ICGA造影早期连续图片的表现特点将视盘水肿可明确分为缺血性和非缺血性;缺血性早期连续像表现为一过性的视盘缺血区与脉络膜区域性低荧光相对应,可直接判定缺血范围和缺血程度,随即血管荧光充盈正常,16眼考虑为对非动脉炎性前部缺血型视神经病变,11眼早期连续像表现为视盘周围脉络膜血管区荧光快速充盈,与正常对照眼表现相同,考虑为视神经炎。 结论:对一些视盘水肿鉴别诊断存在困惑或疑难时,脉络膜血管造影有一过性视盘脉络膜区域性荧光充盈缺损为非动脉炎性前部缺血型视神经病变的特征性改变,该变化有助于视盘水肿性疾病的鉴别,值得重视。

    Abstract:

    "AIM:To study the role of indocyanine green angiography(ICGA) in differential diagnosis between nonarteritic anterior ischemic optic neuropathy (NAION) and optic neuritis. METHODS:Twenty-seven cases 27 eyes with detailed clinical data which were not easily diagnosed by optic disc edema on fundus photography were enrolled. All eyes received examination using the retinal and choroidal angiography(FFA and ICGA). The gender and age matched 20 cases 20 normal control eyes received FFA and ICGA over the same period, and continuous images of each group were analyzed. RESULTS:In 20 cases of control eyes,ICGA examination showed early peripapillary choroidal vascular fluorescence filling in normotension. The performance characteristics of early continuous ICGA pictures from the other 27 eyes showed that the optic disc edema can be clearly divided into ischemic and non-ischemic; ischemic images demonstrated a temporary disc ischemia area and the corresponding choroidal regional hypo-fluorescence, from which the scope and extent of ischemia can be directly determined and the 16 eyes were considered to have NAION; 11 eyes with images demonstrating immediately vascular fluorescence filling in normotension in showed the same as normal control and they were considered to have optic neuritis. CONCLUSION:Some of the optic disc edema is difficult to diagnosis accurately. Choroidal angiography showed that there is a disc choroidal regional fluorescein filling defect for NAION with characteristic changes. These changes contribute to the differential diagnosis and are worthy of attention.

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吕沛霖,王润生. ICGA对NAION与视神经炎的鉴别诊断作用.国际眼科杂志, 2012,12(1):119-121.

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  • 收稿日期:2011-10-21
  • 最后修改日期:2011-12-09
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