CAJ | 학술논문

目的：分析病理性近视（PM）黄斑出血的荧光素眼底血管造影（FFA）、吲哚青绿血管造影（ICGA）及相干光断层扫描（OCT）的影像学特征及临床意义。方法对病理性近视黄斑出血28例（31只眼）进行FFA、ICGA及OCT检查，并对比分析其检查图像。结果单纯型出血15只眼（48.4％），FFA表现：出血部位遮蔽荧光，其中8只眼（53.5％）可见漆样裂纹透见荧光；ICGA表现：造影期间出血部位为淡的低荧光，晚期均可见漆样裂纹性条状低荧光；OCT表现：9只眼（60％）在神经上皮层下和4只眼（26.7％）在色素上皮（ RPE）下可见中高反射光团，周围神经上皮无水肿增厚，其下脉络膜光带连续，其中2只眼（13.3％）OCT无明显改变；新生血管（CNV）型出血16只眼（51.6％），FFA 表现：14只眼（87.5％）为典型性 CNV，2只眼（12.5％）为隐匿性 CNV；ICGA 表现：14只眼（87.5％）为焦点状CNV，无明显染料渗漏，2只眼（12.5％）未见CNV改变；OCT表现：14只眼（87.5％）为RPE光带断裂，RPE上梭形或类圆形中、高反射光团，2只眼（12.5％）为RPE层断裂伴不规则增厚中高反射信号，神经上皮层均增厚水肿。结论病理性近视黄斑出血分为单纯型和新生血管型，新生血管多表现为典型CNV，不同类型的出血其FFA、ICGA、OCT的改变各具特征，合理选择检查方法可提高诊断率，节省费用。
목적：분석병이성근시（PM）황반출혈적형광소안저혈관조영（FFA）、신타청록혈관조영（ICGA）급상간광단층소묘（OCT）적영상학특정급림상의의。방법대병이성근시황반출혈28례（31지안）진행FFA、ICGA급OCT검사，병대비분석기검사도상。결과단순형출혈15지안（48.4％），FFA표현：출혈부위차폐형광，기중8지안（53.5％）가견칠양렬문투견형광；ICGA표현：조영기간출혈부위위담적저형광，만기균가견칠양렬문성조상저형광；OCT표현：9지안（60％）재신경상피층하화4지안（26.7％）재색소상피（ RPE）하가견중고반사광단，주위신경상피무수종증후，기하맥락막광대련속，기중2지안（13.3％）OCT무명현개변；신생혈관（CNV）형출혈16지안（51.6％），FFA 표현：14지안（87.5％）위전형성 CNV，2지안（12.5％）위은닉성 CNV；ICGA 표현：14지안（87.5％）위초점상CNV，무명현염료삼루，2지안（12.5％）미견CNV개변；OCT표현：14지안（87.5％）위RPE광대단렬，RPE상사형혹류원형중、고반사광단，2지안（12.5％）위RPE층단렬반불규칙증후중고반사신호，신경상피층균증후수종。결론병이성근시황반출혈분위단순형화신생혈관형，신생혈관다표현위전형CNV，불동류형적출혈기FFA、ICGA、OCT적개변각구특정，합리선택검사방법가제고진단솔，절성비용。
Objective To investigate the morphological characteristics of pathological myopia using fundus fluores -cein angiography ( FFA) , indocyanine green angiography ( ICGA) and optical coherence tomography ( OCT) .Methods We studied 28 cases (31 eyes) of pathological myopia with macular hemorrhage .FFA, ICGA, and OCT examinations were performed to characterize the morphological changes in these patients .Results Uncomplicated macular hemorrhage was i-dentified in 15 eyes (48.4%).Among these eyes, FFA showed masked fluorescein in the bleeding region .Striated bands of fluorescein could be observed in 8 eyes (53.5%).ICGA showed similar masks at initial phase and fluorescein bands at later phases.OCT revealed high reflection in neurosensory retina (9 eyes, 60%) or in RPE (4 eyes, 26.7%).There was no retina edema.Choroid appeared to be continuous .In 2 eyes, OCT were completely normal.Another group of eyes ex-hibited choroidal neovascularization (CNV;n=16, 51.6%).FFA identified overt CNV in 14 eyes (87.5%) and occult CNV in 2 eyes (12.5%), while ICGA detected scattered CNV in 14 eyes (87.5%) and in two eyes there was no fluores-cein leakage .OCT showed discontinuation and spindle or round shaped high reflection within RPE in 14 eyes.In 2 other eyes, RPE discontinuation was also found along with irregular thickened RPE and neurosensory retina edema .Conclusion Pathologicsl myopia can present with two different types of pathological changes , uncomplicated macular hemorrhage and choroidal neovascularization .Different morphological characters can be identified through FFA , ICGA and OCT examina-tions.