超广角荧光素眼底血管造影(UWFFA)是近年来出现的新技术,可以观察传统7视野之外的视网膜广泛区域的荧光征象,在观察糖尿病视网膜病变(DR)、视网膜静脉阻塞(RVO)和家族性渗出性视网膜病变等血管性疾病周边视网膜时优势明显。传统荧光素眼底血管造影(FFA)的正常荧光和异常荧光表现已较明确,但对正常眼周边荧光特征了解尚少。周边部荧光表现不同于后极部和赤道部,需考虑RPE分布不同、色素差异、血管发育及玻璃体后皮质等因素,还要关注年龄及全身代谢疾病的影响。对于部分荧光表现还需要动态全程分析,结合彩色眼底照相和前置镜检查。明确视网膜不同部位不同时间的正常荧光是判定异常荧光的前提。在临床工作中,特别是在诊断RVO、DR等血管性疾病时,需审慎解读UWFFA周边部荧光征象。不断积累周边部视网膜正常和异常的荧光征象判读经验,进一步提升UWFFA技术应用水平。
Ultra-wide field fluorescein angiography (UWFFA) is a new technique emerging in recent years.UWFFA can observe the fluorescence signs of wide areas of retina beyond the traditional 7-field of vision.UWFFA has obvious advantages in peripheral retina of vascular diseases, such as diabetic retinopathy (DR) , retinal vein occlusion (RVO) and familial exudative retinopathy.Traditional fundus fluorescein angiography (FFA) has accumulated much experience in normal fluorescence and abnormal fluorescence, but little is known about the fluorescence characteristics of normal eye periphery.Periphery fluorescence performance is different from posterior pole and equator.It is necessary to consider the distribution of retinal pigment epithelium (RPE) , pigmentation, vascular development and posterior vitreous cortex.At the same time, more attention should be paid to the influence of age and systemic metabolic diseases on some fluorescence.Light performance also needs dynamic whole-course analysis, combined with color fundus photography and anterior endoscopy analysis.Defining normal fluorescence of different parts of retina at different times is the premise of judging abnormal fluorescence.In clinic, it is necessary to carefully interpret the peripheral fluorescence signs of UWFFA, especially in diagnosis of vascular diseases, such as RVO and DR.It is essential to continuously accumulate experience in interpreting fluorescence signs of normal and abnormal peripheral retina, and further improve the application of UWFFA technology.
陈长征,王晓玲. 正确分析周边部视网膜超广角荧光素眼底血管造影特征[J]. 中华实验眼科杂志,2020,38(07):562-565.
DOI:10.3760/cma.j.cn115989-20190401-00158版权归中华医学会所有。
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