Scoring of dual fluorescein and ICG inflammatory angiographic signs for the grading of posterior segment inflammation (dual fluorescein and ICG angiographic scoring system for uveitis)
Scoring of dual fluorescein and ICG inflammatory angiographic signs for the grading of posterior segment inflammation (dual fluorescein and ICG angiographic scoring system for uveitis)
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DOI：
10.1007/s10792-008-9263-x
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发表时间：
2010-10-01
影响因子：
1.6
通讯作者：
Khairallah, Moncef
中科院分区：
文献类型：
--
作者：
Tugal-Tutkun, Ilknur;Herbort, Carl P.;Khairallah, Moncef
目的提出一种半定量的双荧光血管造影术(FA)和吲哚青绿血管造影术(ICGA)评分系统，用于葡萄膜炎的随访和疗效监测。方法评分系统基于已发表的FA评分系统、标准化的ICGA方案和ICGA在后葡萄膜炎中发现的图解。我们对荧光素和ICG血管造影征象进行了评分，这些征象代表了后段正在进行的炎症过程。我们根据每一种血管造影征象对我们评价眼内活动性炎症的影响对其进行评级。为了能够在FA和ICGA之间进行直接比较，我们将ICGA总分乘以系数2，以调整为FA总分。结果FA征象总分为40分，包括视盘强荧光、黄斑水肿、视网膜血管染色和/或渗漏、毛细血管渗漏、视网膜毛细血管无灌注、视盘新生血管、其他部位新生血管、针状渗漏、视网膜染色和/或视网膜下淤积。ICGA征象的总分为20分，包括早期间质血管强荧光、脉络膜血管炎、暗点或暗区(不包括萎缩)和视盘强荧光。结论本文提出的荧光素和ICG血管造影联合评分系统可帮助评估视网膜和脉络膜炎症的程度，监测疾病进展和治疗反应，并为临床研究提供可比性数据。建议的系统的适用性需要在临床环境中进行测试，并且需要确定观察者内部和观察者之间的差异。
Purpose To propose a semiquantitative dual fluorescein angiography (FA) and indocyanine green angiography (ICGA) scoring system for uveitis that would assist in the follow-up of disease progression and monitoring response to treatment. Methods The scoring system was based on the FA scoring systems, the standardized ICGA protocol, and schematic interpretation of ICGA findings in posterior uveitis that have been previously published. We assigned scores to the fluorescein and ICG angiographic signs that represent ongoing inflammatory process in the posterior segment. We rated each angiographic sign according to the impact it has on our appreciation of active intraocular inflammation. In order to permit direct comparison between FA and ICGA, we multiplied the total ICGA score by a coefficient of 2 to adjust to the total score of FA. Results A total maximum score of 40 was assigned to the FA signs, including optic disc hyperfluorescence, macular edema, retinal vascular staining and/or leakage, capillary leakage, retinal capillary nonperfusion, neovascularization of the optic disc, neovascularization elsewhere, pinpoint leaks, and retinal staining and/or subretinal pooling. A total maximum score of 20 was assigned to the ICGA signs, including early stromal vessel hyperfluorescence, choroidal vasculitis, dark dots or areas (excluding atrophy), and optic disc hyperfluorescence. Conclusion The combined fluorescein and ICG angiographic scoring system proposed herein may help estimate the magnitude of retinal versus choroidal inflammation, monitor disease progression and response to treatment, and provide comparable data for clinical studies. The applicability of the proposed system needs to be tested in clinical settings, and intra- and interobserver variations need to be determined.