脈絡膜新生血管の発育部位の診断におけるインドシアニングリーン螢光眼底造影の有用性

Usefulness of indocyanine green angiography in detecting the location of choroidal neovascularization

　網膜下または網膜色素上皮下に発育する脈絡膜新生血管の部位診断は治療方針の決定に重要である。黄斑下新生血管を外科的に除去した加齢性黄斑変性8眼と特発性脈絡膜新生血管2眼について，新生血管の部位をインドシアニングリーン（ICG）螢光眼底造影で検討した。網膜下新生血管は，造影早期から鮮明に造影され，その茎と新生血管全体を囲む領域それぞれが低螢光で縁取りされていた。色素上皮下の新生血管は，造影早期はその領域が低螢光であり，その内部の過螢光の程度と出現時期は，新生血管の活動性により異なっていた。脈絡膜新生血管の部位の診断にICG螢光眼底造影が有用であった。

Choroidal neovascularization (CNV) grows in the subretinal space, subpigment epithelial space or both. Identification of their location is essential in planning the therapy including subretinal surgery. We performed indocyanine green (ICG) angiography in 8 eyes of age-related macular degeneration and in 2 eyes of idiopathic neovascularization. All the eyes underwent submacular surgery. CNVs located in the subretinal space were characterized by the distinct visibility of neovascular vessels in the early angiographic phase. The CNV and its stalk were surrounded by hypofluorescent rim throughout the phases. In CNVs located in the subpigment epithelial space, the whole area of CNVs appeared as hypofluorescent in the early phase. The degree of hyperfluorescence and the time of its appearance within the area of CNVs differed according to the activity of CNVs. ICG angiography was thus useful in locating the CNVs.