CAJ | 학술논문

目的探讨特殊类型葡萄膜炎患者的眼底图像特征及荧光素眼底血管造影(fundusfluorescein angiography,FFA)的特征.方法回顾分析山西医科大学第一医院2005年4月至2008年2月在眼科门诊行FFA检查并确诊为葡萄膜炎的患者56例98只眼的眼底和FFA图像特征及相关临床资料.结果 56例98只眼葡萄膜炎患者中,双眼发病的有42例84只眼,单眼发病的有14只眼.其中以Behcet病(Behcet disease)最多有25例48只眼;Vogt-小柳-原田病(VKH)有13例25只眼;急性视网膜坏死综合征(ARNS)有10例16只眼;系统性红斑狼疮(SLE)伴葡萄膜炎有8例9只眼.多数患者眼底主要表现为:视盘充血,边界不清,黄斑呈囊样水肿,静脉迂曲扩张,动脉变细,后极部网膜弥漫性水肿.FFA主要表现为:视盘荧光着染且在中后期可见荧光渗漏,黄斑囊样荧光积存,网膜血管轻到中度荧光染色伴渗漏,视网膜深层平面片状荧光渗漏.VKH患者的眼底在赤道前网膜下可见Dalen-Fuch结节.结论不同疾病可引起不同类型的葡萄膜炎.通过FFA检查可确诊特殊类型的葡萄膜炎,对其治疗起到重要的指导意义.
목적 탐토특수류형포도막염환자적안저도상특정급형광소안저혈관조영(fundusfluorescein angiography,FFA)적특정.방법 회고분석산서의과대학제일의원2005년4월지2008년2월재안과문진행FFA검사병학진위포도막염적환자56례98지안적안저화FFA도상특정급상관림상자료.결과 56례98지안포도막염환자중,쌍안발병적유42례84지안,단안발병적유14지안.기중이Behcet병(Behcet disease)최다유25례48지안;Vogt-소류-원전병(VKH)유13례25지안;급성시망막배사종합정(ARNS)유10례16지안;계통성홍반랑창(SLE)반포도막염유8례9지안.다수환자안저주요표현위:시반충혈,변계불청,황반정낭양수종,정맥우곡확장,동맥변세,후겁부망막미만성수종.FFA주요표현위:시반형광착염차재중후기가견형광삼루,황반낭양형광적존,망막혈관경도중도형광염색반삼루,시망막심층평면편상형광삼루.VKH환자적안저재적도전망막하가견Dalen-Fuch결절.결론 불동질병가인기불동류형적포도막염.통과FFA검사가학진특수류형적포도막염,대기치료기도중요적지도의의.
Objective To observe the characteristics of fundus images and fundus fluoresceinangiography (FFA)in special kinds of uveitis.Methods The fudus image of FFA and clinical data of 56patients (98 eyes),who were diagnosed as special kinds of uveitis from Oct,2004 to Oct,2007,wereretrospectively analyzed.Results In the 56 cases (98 eyes)of special kinds of uveitis,bilateral lesionsoccurred in 42 patients(84 eyes), and the remaining 14 cases had the unilateral lesions.Among them, Behcet'sdisease was the most predominant(25 patients, 48 eyes ); followed by Vogt-Koyanagi-Harada syndrome(VKH)(13 patients,25 eyes); the third one was acute retinal necrosis syndrom (ARNS)( 10 patients, 16 eyes)anduveitis combined with systemic iups erthematosus (SLE)(8 patients, 9 eyes).The color fucus of most casesshowed that disc hyperemia with blurred edge,cystoid macular edema (CME),tortuous and ectasy veins,thinningz artery and extensive edema at the posterior pole.The FFA showed that optic disc pigmentation andfluorescence leakage in the advanced stage, cystoid macular fluorescence acumulation, vascular pigmentationcombined with fluorescence leakage, fluorescence leakage in the deep layer of the retina; Dalen-Fuch's noduleswas observed at the peripheral retina in VKH patients.Conclusion The etiopathogenisis of uveitis weredifferent.The fundns and FFA changes of different kinds of uveitis were of characteristics and also had somefeatures in common.Thus definite diagnosis of different kinds of uveitis according to FFA changes was veryconsiderable to guide the therapy.