FLUORESCENT ANGIOGRAPHY

From Big Medical Encyclopedia

FLUORESCENT

ANGIOGRA-FYYa (Greek angeion a vessel + grapho to write, represent) — the method of a research of blood vessels of an eye based on their contrasting by intravenous administration of a flyuorestsein and serial photography.

The foundation was laid for studying of a method by Chao's works and the Phlox (Chao, Flocks, 1958). Novotny Is also scarlet hung (II. R. Novotny, D. L. Alvis, 1961) basic bases F finally formulated. and. also conducted a series of angiographic researches of an eyeground (see). In a crust, time the method of a fluorescent angiography occupied one of the leading places in diagnosis of the diseases connected with defeat of vascular systems of an eye.

Are in recent years implemented in a wedge, to the practician F. and. front segment of an eye (conjunctival and episkleralny vessels), irido-angiography, fluorescent kalib-rometriya of vessels of a retina. For the purpose of increase in informational content F. and. are developed stereoscopic F.

and., cineangiography, television angiography.

The essence of a method is that at intravenous administration of a soluble flyuorestsein of a particle of dye pass on vascular system of an organism, including and on vessels of an eye; this stage is registered by means of a series of photos. Flyuorestsein gets through a wall of choroidal capillaries owing to an originality of their structure consisting in an okonchatost (windowing) of an endothelium. The layer of a pigmental epithelium of a retina is a barrier to passing of a flyuorestsein from a ho-rioidea in a retina; disturbance of an integrity of an epithelium gives local or widespread hyper fluorescence of a retina. In pictures gradual contrasting of the vessels accepting white color and therefore allocated against the background of an eyeground is visible. Retinal vessels become permeable for a flyuorestsein at neovascularization (see the Retinopathy), inflammatory processes, an arteriolonekroza, an angiomatosis, etc. Hemorrhages in a retina do not absorb flyuorestsein and come to light in the form of black spots; hemorrhages differ in it from Mick * a roanevrizm, to-rye fluoresce.

Special training of the patient for a research is not required. Investigated seat in front of the camera. Quickly enter 5 or 10% into an elbow vein solution of a flyuorestsein at the rate of 10 mg on 1 kg of body weight. Right after the termination of an injection begin serial photography of an eyeground.

For F. and. apply various models of special cameras — a fuiduskamer, e.g. «Reti-nofot» (GDR) or an automatic funduskamera of «Zeiss-Opton» (Germany) having two lenses (one gives increase by 3,75 times that allows to photograph separate zones of an eyeground, and another — by 2,56 times in this connection it is used for obtaining survey angiograms).

Photography is carried out on a highly sensitive monochromatic negative and reversible film; on color films: less contrast image turns out. The technique of photography can be different. It is more convenient to begin shooting with the central area of a retina and an optic disk and then to photograph consistently four quadrants of an eyeground starting with verkhnenaruzhny for the right eye and verkhnevnutrenny — for left; at the same time the patient roundabouts by an eye clockwise ask to make.

On the basis of a serial fotorep of a stration of passing of a flyuorestsein on vessels of a retina and a horioidea allocate separate phases of its circulation. By the first it is contrasted horioideya — a choroidal phase; on the angiogram fluorescence of an eyeground and a dark not fluorescent macular zone is harmful that is connected with shielding of a makula more dense pigmental epithelium. Then the early arterial phase (fig., a) in the form of contrasting of separate retinal arterioles is defined. Behind it there comes the arterial phase when all arterioles of a retina are filled with a contrast agent. The following phase — early venous, at a cut at the edges of a wall of a vein there are white strips of a flyuorestsein, and the ground mass of a venous blood remains nekont-rastirovanny (fig., b). The early venous phase is replaced venous, at a cut all venous network of a retina is contrasted. At the same time contrasting of arteries still remains therefore allocate also arteriovenous phase when both arterial, and venous vessels are completely filled with a contrast agent (fig., c). Then flyuorestsein begins to leave a retina that is visible on decrease in contrasting of arterioles at even the filled veins. After that flyuorestsein gradually leaves a retina, but sometimes it appears in a late phase of an angiography, in already more low concentration again — a recirculation phase.

Time of circulation of a flyuorestsein at healthy faces aged from 16 up to 60 years makes in a choroidal phase apprx. 9 sec., in early arterial — 10 — 12 sec., in early venous — apprx. 11 sec.

During the performance of a research the individual intolerance of a flyuorestsein is in rare instances possible, edges it is shown by nausea and vomiting; usually observe emergence of yellowish coloring of skin and yellow color of urine; these phenomena completely pass within a day.

Bibliography: Nesterov A. P., B at -

N and A. Ya. N ikatsnelso N of JI. And * Intraocular pressure, Physiology and


Fig. The fluorescent angiogram of vessels of an eyeground is normal (the contrasted vessels — white color; it is not contrasted - nye black): and — an early arterial phase; — an early venous phase; in — an arteriovenous phase.


pathology, page 207, M. 1974;

Novot ny H. R. a. Alvis D. L. A method of photographing fluorescence in circulating blood in the human retina, Circulation, v. 24, p. 82, 1961; S with h a t z H. o. Interpretation of fundus fluorescein angiography, St Louis, 1978; Wessing A. Fluorescein angiography of the retina, Textbook and atlas, St Louis, 1969.

L. A. Katsnelson.

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