Analysis of Fluorescein Angiograms during a One Year Period

社區型醫院眼底螢光血管攝影之分析

10.6200/TCMJ.2006.3.3.04

郭麗琳(Li-Lin Kuo)；楊昌叔(Chang-Sue Yang)；蔡景耀(Ching-Yao Tsai)；許聖民(Sheng-Min Hsu)；翁林仲(Lin-Chung Woung)

眼底螢光血管攝影 ； 糖尿病視網膜病變 ； 老年性黃斑部退化 ； 視網膜靜脈阻塞 ； 雷射光凝固術 ； fluorescein angiography ； diabetic retinopathy ； age-related macular degeneration ； retinal vein occlusion ； laser photocoagulation

北市醫學雜誌

3卷3期（2006 / 03 / 01）

218 - 225

英文

目的：我們回顧分析一年來眼底螢光血管攝影檢查，以研究統計其檢查之適應症與治療視網膜病患的臨床實用價值。方法：藉回溯性分析自2001年10月至2002年11月之間，研究在臺北市立中興醫院眼科一年來接受眼底螢光血管攝影病人。結果：共收集365例檢查，我們發現，接受眼底螢光血管攝影的臨床診斷最多為糖尿病視網膜病變126例(34.5%)，其次為年齡相關性黃斑退化59例(16.2%)，視網膜血管疾病46例(12.6%)，高度近視合併黃斑病變38例(10.4%)，其餘包括囊狀黃斑水腫，視神經疾病，葡萄膜炎，眼內腫瘤等。檢查時發生不良之全身性反應有4例。眼底螢光血管攝影檢查的結果與95.3%的臨床診斷相符合，對有典型臨床表徵病例而言，眼底螢光血管攝影並無助於診斷建立，但有助於決定是否需要雷射治療及後續評估。但對一些慢性視網膜靜脈阻塞與非典型黃斑部病變，則極有助於確立診斷。結論：眼底螢光血管攝影，對糖尿病視網膜病變與視網膜靜脈阻塞疾病，判讀其無血流灌注區與新生血管之發生，有助於決定做雷射治療。對滲出性黃斑部退化疾病，分辨其脈絡膜新生血管為境界分明與否，極有助於規劃下一步雷射治療計畫。

Background and Purpose: This study was designed to evaluate indications for fluorescein angiography (FAG) and its usefulness in the clinical management of vitreoretinal diseases. Methods: We retrospectively reviewed and analyzed the medical records of patients who underwent FAG from Oct. 2001 to Nov. 2002 at the Zhongxing Branch of Taipei City Hospital. Results: There were a total of 365 FAG examinations included in this study. Pre-examination diagnoses included diabetic retinopathy (34.5%), age-related macular degeneration (16.2%), retinal vascular diseases (12.6%) and high myopia (10.4%), as well as cystoid macular edema, optic nerve disease, uveitis and ocular tumor. The results of the FAG examinations were compatible with the clinical diagnoses given before FAG in most patients (95.3%) in our study. The clinical value of FAG was not in the establishment of a diagnosis in most cases but rather in making decisions regarding laser treatment and serial follow-up evaluation. FAG is very helpful in defining the diagnosis of easily misdiagnosed conditions such as chronic branch retinal vein occlusion, retinal arterial macroaneurysm and atypical macular degeneration. Conclusion: FAG is useful in the evaluation and documentation of retinal neovascularization and capillary non-perfusion in newly-diagnosed diabetes patients before laser photocoagulation treatment. Angiography is also an invaluable tool in defining the feature of choroidal neovascularization (classic or occult), which can play an important role in determining the modality of new laser therapy.