Study on endoscopic fluorescein angiography of extreme peripheral retina

我们在玻璃体切除术中应用眼内窥镜进行术中荧光素血管造影。我们研究了常规眼底照相机未观察到的视网膜边缘和睫状体的荧光素表现。首先，我们发现许多患有增殖性糖尿病视网膜病变的眼睛在视网膜极端外周有异常的发现，这与视网膜循环障碍的严重程度有关。其次，我们将该技术应用于细菌性眼内炎、葡萄膜炎等炎症性疾病。细菌性眼内炎患者，尽管视网膜功能严重异常，但荧光素表现正常，可能是细菌内毒素对内视网膜的可逆性损伤。在葡萄膜炎中，在玻璃体出血的手术中，荧光素血管造影显示睫状体平面部有新生血管形成，我们可以在手术时成功治疗。我们的结论是，新血管的形成可以在炎症过程中发生，而与血管闭塞无关。第三，我们成功地通过记录术中荧光素血管造影直接分析平均视网膜循环时间。除了荧光素血管造影外，我们还成功记录了增生性糖尿病视网膜病变和年龄相关性黄斑变性患者的术中吲吲酚绿血管造影，我们发现即使在手术切除后脉络膜新血管仍经常存在。老年性黄斑变性已成为致盲的主要原因之一，我们应继续与这些新技术作斗争。

We developed intraoperative fluorescein angiography during vitrectomy using ophthalmic endoscope. We studied the fluorescein findings of extreme retinal periphery and ciliary body which had not been observed by regular fundus camera. First of all, we found that many eyes with proliferative diabetic retinopathy showed unusual findings in the extreme retinal periphery, which correlated the severity of retinal circulatory disturbances. Second, we applied this technique for the inflammatory disease such as bacterial endophthalmitis and uveitis. In bacterial endophthalmitis, the fluorescein findings appeared normal despite the severe functional abnormalities of the retina, which might be reversible retinal damage of inner retina by bacterial endotoxins. In uveitis, the fluorescein angiography revealed the neovascularization at the pars plana of ciliary body during surgery for vitreous hemorrhage which we could treat successfully at the time of surgery. We concluded that the neovascularization could develop during the inflammatory process not associated with vascular occlusion. Third, we successfully analyzed the mean retinal circulation time directly by recording the fluorescein angiography during operation.In addition to fluorescein angiography, we successfully recorded intraoperative indocyanin green angiography for patients with proliferative diabetic retinopathy and age-related macular degeneration in which we found choroidal new vessels remained frequently even after surgical removal. Age-related macular degeneration has become one of chief cause of blindness which we should continue to fight against with these new techniques.