荧光素眼底血管造影（fundus fluorescein angiography, FFA）是眼底疾病诊疗不可或缺的检查技术。虽然开展已有半个世纪，但临床工作者在FFA操作的规范性、科学性、安全性和结果同质性仍有不少顾虑和问题，同时缺乏相关指南和共识可供参考。中国微循环学会眼微循环专业委员会眼影像学组专家就FFA操作规范达成本共识，就开展FFA的条件和配置、适应证和禁忌证、检查前准备、检查操作程序、不良反应及处理、造影后患者告知和处理、造影报告等方面为FFA临床操作工作者提供建议和指导，以期在临床实践中获取良好眼底影像、减少不良反应、提高检查质量效率。
Fundus fluorescein angiography (FFA) is an indispensable examination for the diagnosis and treatment of ocular fundus diseases. Although FFA has been carried out for half a century, clinicians still have many concerns and problems in the standardization, scientificity, safety and result homogeneity of FFA practice, and there is a lack of relevant guidelines and consensus for reference. The experts of the Ophthalmic Imaging Group of the Ocular Microcirculation Division of the Chinese Society of Microcirculation reached a consensus on the standardized practice of FFA, providing suggestions and guidance for FFA operators about the clinical conditions and configurations, indications and contraindications, pre-examination preparation, examination procedures, adverse reactions and treatment, patient notification, and angiography reports, in order to obtain good fundus images, reduce adverse reactions, and improve the quality and efficiency of FFA examinations in clinical practice.
目的：探讨不同病变阶段视网膜色素变性患者的脉络膜血管状态。方法：回顾性分析云南省第二人民医院眼科2000年1月至2015年4月诊断为原发性视网膜色素变性的患者226例(452眼)的眼底特征，并复习相关文献，重点分析总结脉络膜血管情况。结果：31例(62眼)病变前期患者，荧光素眼底血管造影显示动脉期脉络膜血管及视网膜血管充盈正常，未出现充盈延迟或缺损现象。25例(50眼)病变早期患者，荧光素眼底血管造影显示动脉前期可见脉络膜背景荧光显示，部分脉络膜毛细血管未同时充盈，动脉期时上述部分完成充盈。106例(112眼)病变中期患者，荧光素眼底血管造影显示动脉期出现部分脉络膜毛细血管萎缩区，仅能看到残存的粗大脉络膜血管，随造影过程的进展，此区域并未出现充盈，即呈现永久的脉络膜毛细血管充盈缺损。64例(128眼)病变晚 期患者荧光素眼底血管造影显示，广泛的脉络膜毛细血管萎缩区，其间可见残存的脉络膜粗大血管，至造影晚期均呈现充盈缺损，萎缩区边缘随造影过程呈强荧光表现。结论：荧光素眼底血管造影可显示脉络膜血管萎缩变化情况，这一指标可作为反映不同病变阶段视网膜色素变性患者病情进展变化的重要依据。
Objective: To investigate clinical characteristics of choroid in different stages of retinitis pigmentosa. Methods: The characteristics of fundus, visual conditions and characters of choroid of 226 cases (452 eyes) patients with retinitis pigmentosa in No. 2 People’s Hospital of Yunnan Province from Jan.2000 to Apr.2015 were retrospectively analyzed. Results: Fundus fluorescein angiography of 31 cases (62 eyes) before early stage showed: arterial choroidal and retinal vascular filling normal, filling delay or defect phenomenon does not be observed. Fundus fluorescein angiography 25 cases (50 eyes) patients in early disease showed: preliminary choroidal artery background fluorescence was displayed, at the same time, part of the choriocapillaris was not filling, the filling was completed in arterial stage. Fundus fluorescein angiography of 106 cases (112 eyes) patients in the medium-stage showed: arterial phase appears part choriocapillaris atrophy area, thick choroidal vessels can be seen, with the progress angiography procedure, filling was not be observed in this area, which presents permanent choriocapillaris filling defect. Fluorescein angiography of 64 cases (128 eyes) in patients in advanced stage showed widespread choriocapillaris atrophy area, during which thick choroidal vessels remaining filling defect in late stage, atrophic area with a contrast edge high fluorescence performance. Conclusion: Fluorescein angiography can show choroidal atrophy changes, it can be used as an indicator to assess the progression of retinal changes in patients with retinitis pigmentosa.
目的: 观察老年性黄斑变性(Age-related macular degeneration, AMD) 和息肉状脉络膜视网膜病变(Polypoidal choroidal vasculopathy, PCV) 患者眼底陈旧性出血在吲哚青绿血管造影(Indocyanine green angiography, ICGA) 中的自发荧光表现。方法: 对伴有眼底陈旧性出血的AMD和PCV患者共36例(36只眼)行ICGA检查。受试者在进行ICGA检查前, 均经过详细的眼底镜检查、眼底彩色照相及荧光素眼底血管造影(Fundus fluorescein angiography, FFA) 检查。结果: 眼底陈旧性出血灶 ICGA 均表现出相应的自发荧光。陈旧性出血灶呈浅灰黄色, 其自发荧光的形态大小与眼底彩色图像所示的陈旧性出血灶相一致, 边界清晰; 造影后期陈旧性出血灶的自发荧光强度最强，与 AMD 的斑状及焦点状脉络膜新生血管 (Choroidal neovasculari-zation, CNV) 及 PCV 的息肉状脉络膜血管扩张灶的荧光表现不同。陈旧性眼底出血的自发荧光多与 CNV 或息肉状病灶重叠或位于其边缘(27只眼, 75%) 。结论: ICGA 中陈旧性眼底出血所致的自发荧光易与 CNV 及息肉状病灶性强荧光相混淆, 将眼底彩色图像与 ICGA 图像对比分析及掌握其与CNV及息肉状血管扩张灶的不同荧光特性有助于鉴别诊断。
Objective: To investigate the autofluorescence of stale fundus haemorrhage in age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) with indocyanine green angiography (ICGA) .Methods: The color photographs and ICGA were performed in 36 eyes of 36 cases of exudative AMD or PCV with stale fundus haemorrhage. All of the cases were examined by funduscopy and fundus fluorescein angiography (FFA) .Results: Autofluorescence could be observed in all of the stale haemorrhage cases. Stale haemorrhage showed grayish color and the shapes and sizes of autofluoresence in ICGA were in accordance with those of the stale haemorrhage in the color photographs. The boundaries of autofluorescence were clear and the intensities were strong. The percentage of choroidal neovascularization (CNV) or PCV in or beside stale haemorrh-age was significantly higher than that outside the stale haemorrhage (27 eyes, 75%) .Conclusions: Autofluorescence of stale haemorrhage in ICGA can be mixed up with the high fluorescence of CNV and grapes-like polypoidal dilatation. It is helpful to compare the color photographs with ICGA and recognize the different ICGA characteristics in the assessment of ICGA results in these circumstances.
目的：探讨应用数字化广域成像系统RetCam3行婴幼儿口服荧光素钠眼底血管荧光造影(fluorescein fundus angiography，FFA)的护理。方法：选择2018年8月至2019年12月在广州中山大学中山眼科中心小儿眼病综合科就诊的眼底疾病婴幼儿78例，应用RetCam3进行口服法FFA检查及护理，将护理要点进行总结。结果：所有患儿安全、顺利完成检查，检查过程中均未发生异常病情变化或与检查、药物相关的并发症。经FFA确诊家族性渗出性玻璃体视网膜病变(familial exudative vitreoretinopathy ，FEVR)26例，早产儿视网膜病变(retinopathy of prematurity ，ROP)23例，色素失禁症患者6例；玻璃体积血患者3例；视网膜母细胞瘤患者3例；牵牛花综合征患者1例；视网膜色素变性患者3例；弓蛔虫眼病患者1例；原始永存玻璃体患者2例；不明原因眼底病变患者5例，单眼视网膜皱襞患者1例，先天性小眼球患者1例，巨细胞病毒感染患者1例，先天性黄斑发育不良患者1例；Coats病患者1例。结论：应用RetCam3行婴幼儿口服法FFA是一种安全、有效的检查方法。规范、恰当的护理配合能够保证检查准确、顺利地完成。
Objective: To share the nursing experience of RetCam3 ultra-widefield oral fluorescein fundus angiography (FFA) in infants with fundus diseases. Methods: Seventy-eight infants with fundus diseases admitted to General Department of Pediatric Ophthalmology in Zhongshan Ophthalmic Center, Sun Yat-sen University from August 2018 to December 2019 were recruited. Oral FFA was carried out using the 130-degree lens of RetCam3, and the key points of nursing were summarized. Results: No complications related to the examination and drugs occurred after oral FFA with an appropriate nursing manner. FFA confirmed 26 cases of familial exudative vitreoretinopathy,23 cases of retinopathy of prematurity and 6 cases of pigment incontinence. Vitreous hematoma was observed in 3 patients, retinoblastoma in 3 patients, Morning Glory syndrome in 1 patient, retinitis pigmentosa in 3 patients,Ascaris lumbricoides eye disease in 1 case, original permanent vitreous body in 2 patients, unexplained fundus lesions in 5 patients, monocular retinal fold in 1 patient, congenital micro-eyeball in 1 patient, cytomegalovirus infection in 1 patient, congenital macular dysplasia 1 patient and Coats disease in 1 patient. Conclusion: Oral FFA with RetCam3 is an effective and safe detection method for infants. Standard and proper nursing can ensure the examination can be performed accurately and smoothly.
目的：探讨耳穴压豆疗法预防眼底荧光血管造影(fluorescence fundus angiography，FFA)胃肠反应的效果。方法：选取2019年10月至2020年4月在汕头大学·香港中文大学联合汕头国际眼科中心特殊检查科行眼底荧光素血管造影检查的患者583例，实验组298例，对照组285例。对照组在检查前予常规护理措施。试验组检查前在对照组的基础上实施耳穴压豆疗法。比较两组受检者在检查期间的胃肠道反应情况及配合度和舒适度的区别。结果：试验组胃肠道反应发生率低于对照组(P<0.05)。配合度得分试验组为(2.87±0.35)分，对照组为(2.96±0.19)分，两组差异有统计学意义(P<0.001)。舒适度得分试验组为(3.93±0.70)分，对照组为(3.91±0.56)分，两组差异无统计学意义(P=0.122)。结论：耳穴压豆疗法可以降低FFA检查胃肠道反应发生率，疗效安全可靠，操作简便易行，另外，耳穴压豆方法不会造成患者检查时舒适度下降，有助于患者顺利安全完成检查。
Objective: To explore the prevention efficacy of auricular points plaster therapy on gastrointestinal reaction caused by fundus fluorescein angiography (FFA). Methods: We selected 583 patients who underwent fundus fluorescein angiography in the special examination department of our hospital from October 2019 to April 2020, and divided these patients into experimental group (n=298) and control group (n=285). The control group was given routine nursing measures before the examination. The experimental group was treated with auricular points plaster therapy on the basis routine nursing measures before the examination. The gastrointestinal reactions, degree of patient compliance and comfortableness during the examination were compared between the two groups. Results: The incidence of gastrointestinal reaction in the experimental group was lower than that of control group (P<0.05). The score of patient compliance degree was 2.87±0.35 in the experimental group and 2.96±0.19 in the control group, and there was a significant difference between the two groups (P<0.001). Degree of comfortableness was 3.93±0.70 in the experimental group and 3.91±0.56 in the control group. There was no significant difference between the two groups (P=0.122). Conclusion: Auricular points plaster therapy can reduce the incidence of gastrointestinal reaction caused by fundus fluorescein angiography, which is safe and reliable, easy to operate. In addition, the auricular points plaster therapy will not affect patient’s comfortness during examination, and will comply the patients to the examnination smoothly. is helpful for patients to complete the examination comfortably and safely
目的：观察喉罩通气吸入七氟醚麻醉在小儿眼底荧光素造影检查(fundus fluorescein angiography，FFA)期间眼位情况、眼球运动的发生率和丙泊酚调整眼位的有效率。方法：回顾性分析2018年6月至2019年12月七氟醚麻醉下接受FFA的儿童的病例资料，记录检查开始时眼位分级、检查中眼球运动发生率、丙泊酚调整眼位的有效率、麻醉后恢复自主活动时间以及不良事件。结果：纳入1~9岁患儿54例，检查开始时42.6%(23/54)的患者眼位1级，51.9%(28/54)的患者眼位2级，5.6%(3/54)的患者眼位3级，检查中眼球运动发生率为61.1%(33/54)。13%(7/54)的患儿需丙泊酚干预，丙泊酚1 mg/kg纠正眼位的有效率为100%。患儿麻醉后恢复正常活动的平均时间为24.4 min，未发生不良事件。结论：喉罩复合七氟醚的麻醉可为门诊小儿眼底荧光造影提供相对满意的麻醉质量，患者在麻醉后可迅速恢复日常活动，丙泊酚可迅速纠正检查中眼位不正。
Objective: To observe the eye position, the incidence of eye movement and the efficacy of propofol on correcting eccentric eyeball position in children undergoing examination of outpatient fundus fluorescein angiography (FFA) with inhaled sevoflurane via laryngeal mask airway. Methods: Children undergoing FFA with sevoflurane anesthesia from June 2018 to December 2019 were retrospectively reviewed. Eye position at the beginning of examination, incidence of eye movement during examination, the efficiency of propofol on correcting eccentric eyeball position during procedure, the time to resume normal activities, and adverse events were recorded. Results: Fifty-four children aged 1–9 years were included in this study. The rates of eye position from grade one to grade three at the beginning of examination were 42.6% (23/54), 51.9% (28/54), and 5.6% (3/54), respectively. The incidence of eye movement during examination was 61.1% (33/54). 13% (7/54) of children with unsatisfactory eye-position needed intervention with propofol. The efficacy of propofol (1 mg/kg) in correcting eye position was 100%. The mean time to return normal activities was 24.4 min. There were no any adverse events during the peri-anesthetic period. Conclusion: Inhaled sevoflurane via LMA can provide appropriate anesthesia for outpatient FFA in children. Children can resume daily activities soon after anesthesia. Propofol can return the incorrect eye position during examination
