Evaluation of peripheral retinal angiopathy with endoscopic fluorescein angiography

为了评估远周边眼底和睫状体的血管反应，我在玻璃体切除术中对50多只患有各种眼底疾病的眼睛进行了内窥镜荧光素血管造影，包括糖尿病视网膜病变、视网膜静脉阻塞、眼结节病和年龄相关性黄斑变性。内窥镜血管造影被证明是有用的，以确定在手术中的治疗方式。我在23只糖尿病视网膜病变患者的玻璃体切除术中进行了内窥镜荧光素血管造影。该技术能够精细检测视网膜新生血管和非灌注区域。由于这一优点，适当地进行了增生组织的内激光光凝和分层。23只眼中5只眼眼底及睫状体远周部荧光增强。此发现提示有红变或前玻璃体纤维血管增生的早期征象。3眼睫状体渗出黄绿素染料，似反映房水渗漏 ...更多信息 分泌。视网膜静脉阻塞的患眼，内镜血管造影显示出血玻璃体切除术后无灌注区和新生血管的范围，有些患眼的大范围无灌注区累及眼底远周边直至锯齿缘。沿锯齿缘偶见沿着网状强荧光。这些发现有助于设计激光光凝。术中去除黄斑前膜后，术后黄斑瓣状荧光逐渐减弱. 12例眼结节病患者在玻璃体切除术中，内镜血管造影显示黄斑囊样水肿和周边脉络膜染料渗漏。在玻璃体凝胶和玻璃体后膜去除后，这些强荧光逐渐减少。提示玻璃体是化学介质的储存库，玻璃体后膜是结节病黄斑囊样水肿的主要原因.对于年龄相关性黄斑变性患者，玻璃体切除术期间内窥镜血管造影可清楚显示脉络膜新生血管的范围。它有助于完全清除脉络膜新生血管。在玻璃体切除术中，内窥镜血管造影可用于监测波动灌注压力下的视网膜循环。少

To evaluate the vascular reaction in far peripheral fundus and ciliary body, I performed endoscopic fluorescein angiography during vitrectomy in more than 50 eyes with various fundus diseases including diabetic retinopathy, retinal vein occlusion, ocular sarcoidosis and age-related macular degeneration. Endoscopic angiography proved to be useful to determine the therapeutic modalities during surgery.1. I performed endoscopic fluorescein angiography in 23 eyes with diabetic retinopathy during vitrectomy. This technique enabled fine detection of retinal neovascularization and nonperfusion areas. Because of this advantage, endolaser photocoagulation and delamination of proliferative tissue was suitably performed. Hyperfluorescence was observed in far peripheral fundus and ciliary body in 5 of the 23 eyes. This finding suggested early sign of rubeosis or anterior hyaloidal fibrovascular proliferation. Fluorescein dye leaked from the ciliary body in 3 eyes, which seemed to reflect aqueous s … More ecretion.2. In eyes with retinal vein occlusion, endoscopic angiography revealed extent of nonperfusion areas and neovascularization after resection of hemorrhagic vitreous, In some eyes, large nonperfusion area involved far peripheral fundus until the ora serrata. Reticular hyperfluorescence was occasionally seen along the ora serrata. These findings helped to design the laser photocoagulation. After premacular membrane was removed during surgery, macular pettaloid hyperfluorescence gradually decreased postoperatively.3. Endoscopic angiography showed cystoid macular edema and dye leakage from the peripheral choroid during vitrectomy in 12 eyes with ocular sarcoidosis. After removal of vitreous gel and posterior hyaloid membrane, these hyperfluorescence gradually decreased postoperatively. It suggested that the vitreous plays as a reservoir of the chemical mediators and the posterior hyaloid membrane worsens cystoid macular edema in ocular sarcoidosis.4. In eyes with age-related macular degeneration, endoscopic angiography clearly showed the extent of choroidal neovascularization during vitrectomy. It helped complete removal of choroidal neovascularization. Endoscopic angiography was useful to monitor the retinal circulation under undulating infusion pressure during vitrectomy. Less