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目的 观察急性视网膜坏死综合征 (ARNS)的荧光素眼底血管造影 (FFA)和吲哚青绿血管造影 (ICGA)图像特征及在临床诊断中的应用价值。 方法 回顾性分析 2 0例临床诊断为 ARNS的患者2 8只患眼的眼底、FFA和 ICGA检查资料。 结果 FFA图像中 ,视盘边界不清、晚期强荧光 2 4只眼 ,占85 .71% ;周边部病灶区视网膜动静脉血管广泛闭塞 2 3只眼 ,占 82 .14 % ,部分仅见闭塞的血管暗影 ,检眼镜检查所见的部分呈白线状的血管仍有荧光素通过 ;病灶区与较正常视网膜交界处较多荧光素渗漏点者2 2只眼 ,占 78.5 7% ;视网膜脱离 2 0只眼 ,占 71.4 2 % ,其中 9只眼未发现视网膜裂孔 ,占视网膜脱离者的4 5 .0 0 % ;8只眼黄斑囊样水肿 ,占 2 8.5 7%。ICGA图像中 ,视盘强荧光 8只眼 ,占 2 8.5 7% ,其中有 5只眼晚期视盘内见颗粒状染色 ;周边部病灶区脉络膜血管模糊不清者 2 0只眼 ,占 71.4 2 % ;病灶区脉络膜散在片状弱荧光区 19只眼 ,占 6 7.85 % ;ICGA晚期图像中 ,视网膜血管内栓子及视网膜血管闭塞区清晰可见。 结论 ARNS的 FFA表现主要是视盘强荧光和视网膜血管闭塞 ;ICGA主要表现是病灶区脉络膜血管模糊不清及散在片状弱荧光区。两种检查联合使用 ,可进一步了解病变损害的程度以及脉络膜与视网膜之间的相互关系
Objective To observe the features of fluorescein fundus angiography (FFA) and indocyanine green angiography (ICGA) in acute retinal necrosis syndrome (ARNS) and its clinical value. Methods A retrospective analysis of 20 patients with clinically diagnosed ARNS in 28 eyes with fundus, FFA and ICGA examination data. Results In the FFA images, the optic disc border was unclear, the late strong fluorescent 24 eyes, accounting for 85.71%; peripheral retinal retinal artery and vein extensive occlusion of 23 eyes, accounting for 82.14%, only partially occluded vessels Shadow, ophthalmoscopy showed some of the white line of blood vessels still fluorescein; lesion area and the more normal retinal junction more fluorescein leakage point 2 2 eyes, accounting for 78.5 7%; retinal detachment 2 0 eyes, accounting for 71.4%, of which 9 eyes did not find retinal tears, accounting for 45.0% of retinal detachment; macular cystoid edema in 8 eyes, accounting for 8.57%. In ICGA images, 8 eyes with strong fluorescence of optic disc accounted for 2 8.57%. Among them, 5 eyes showed granular staining in the late stage of optic disc. 20 cases with vague choroidal vascularization in peripheral lesion were 71.4%. The focal choroid scattered in weak flaky 19 eyes, accounting for 6 7.85%; ICGA late images, retinal intravascular emboli and retinal vascular occlusion area clearly visible. Conclusions The main manifestations of FFA in ARNS are the strong fluorescence of the optic disc and the occlusion of the retinal vessels. The main manifestation of ICGA is the unclear choroidal vasculature in the focal area and the scattered weak fluorescence area. The combined use of the two tests provides further insight into the extent of lesion damage and the relationship between the choroid and the retina