摘要
目的观察息肉样脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)的临床特征。方法回顾性分析我院自2008年7月至2012年4月确诊为PCV的174例(206眼)患者的眼底彩色照相、荧光素眼底血管造影(fluorescein fundus angiog-raphy,FFA)、吲哚青绿血管造影(indocyanine green angiography,ICGA)和相干光断层成像(optic coherence tomography,OCT)结果,并进一步分析。结果眼底表现:橘红色病灶146眼(70.9%),斑片状视网膜出血79眼(38.3%),硬性渗出71眼(34.5%),玻璃膜疣8眼(3.9%)。FFA表现:144眼(70.0%)早期见密度不均的斑点状强荧光,晚期呈强度不均的斑驳状强荧光斑片;49眼(23.8%)表现为大片遮蔽荧光;色素上皮脱离为99眼(48.1%)。ICGA表现:息肉样强荧光位于黄斑区149眼(72.3%),视盘区20眼(9.7%),血管弓区19眼(9.2%);脉络膜异常分支血管网149眼(72.3%);晚期地图样强荧光110眼(53.4%)。OCT表现:PCV的异常分支血管网表现为视网膜色素上皮层呈扁平波纹状隆起,RPE层与Bruch膜之间可见中至高的反射信号68眼(41.5%);PCV的异常分支血管网表现为RPE层较高隆起,其下可见中高反射和(或)出血(浆液)信号64眼(39.0%)。结论 PCV以视网膜下橘红色病灶为其眼底特征;FFA造影早期见密度不均的斑点状强荧光,晚期呈强度不均的斑驳状强荧光斑片,浆液性或出血性色素上皮脱离多见;ICGA造影表现为息肉样强荧光,脉络膜异常分支血管和晚期地图样强荧光,息肉样病灶多位于黄斑部;PCV的异常分支血管网OCT表现为视网膜色素上皮层和Bruch膜之间的中高反射信号。
Objective To describe the clinical characteristics of polypoidal cho- roidal vasculopathy （PCV）. Methods This retrospective study enrolled 174 patients （206 eyes） in our department who were diagnosed as PCV from July 2008 to April 2012. Patients underwent fundus photography, fluorescein angiography （FFA）, indocyanine green angiography （ICGA）, and optic coherence tomography （OCT）, the examination results were analyzed. Results Fundus photography showed that protruded orange- red elevated lesions, Subretinal hemorrhage and hard exudate appeared in 146 eyes （70. 9% ） ,79 eyes（38.3% ） and 71 eyes（34.5% ） ,respectively. Drusen was found in 8 eyes （3. 9% ）. FFA indicated that dotted hyperfluorescence presented in 144 eyes （ 70. 0% ） in early phase and patches of hyperfluorescence in late phase. Blocked fluores- cence could be found in 49 eyes（23.8% ） and pigment epithelial detachment in 99 eyes （48. 1% ）. In ICGA,polypoidal lesions were seen in the macula area（ 149 eyes,72.3% ）, arcade area（ 19 eyes, 9.2% ） and peripapillary area（ 20 eyes, 9.7% ）, respectively. Ab- normal branching choroidal networks were seen in 149 eyes （72.3%）, later geographic hyperfluorescence was observed in 1 l0 eyes（53.4% ）. Findings in OCT included that ar- eas of moderate reflectivity indicating branching vascular network between the fluctua- ting retinal pigment epithelium and Bruch membrane were seen in 58 eyes（41.5% ） ,and 54 eyes （39. 0% ） had moderate reflectivity of branching choroidal networks and/or hemorrhage between high doom-like PED. Conclusion PCV with the protruded or- ange-red elevated lesions are its characteristics in findings of fundus examination;FFA discover the dotted hyperfluorescence in early phase, patches of hyperfluorescence in late phase, with or without blocked fluorescence, the hemorrhagic PED or serous PED is more common. ICGA show the polypoidal lesions, abnormal branching choroidal net- works, late geographic hyperfluorescence. Most of polypoidal lesions are located in the macula area. OCT show the areas of moderate reflectivity between RPE and Bruch membrane.
出处
《眼科新进展》
CAS
北大核心
2013年第3期282-285,共4页
Recent Advances in Ophthalmology
关键词
黄斑变性
息肉样脉络膜血管病变
荧光素眼底血管造影
吲哚青绿血管造影
相干光断层成像
macular degeneration
polypoidal choroidal vasculopathy
fundus fluo-rescein angiography
indocyanine green angiography
optic coherence tomography
