The clinical features of polypoidal choroidal vasculopathy
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
- Issue:
- 5
- DOI:
- 10.3760/j.issn:1005-1015.2003.05.002
- Key Word:
- 视网膜疾病/诊断;脉络膜疾病/诊断;黄斑变性;荧光素血管造影术;吲哚花青绿/诊断应用
Abstract： 目的观察息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)的临床特征. 方法回顾分析1999年8月～2002年10月临床诊断为脉络膜新生血管(choroidal neovascularization,CNV)性疾病的71例连续病例的142只眼的眼底检查、荧光素眼底血管造影(fundus fluorescein angiography,FFA)、吲哚青绿血管造影(indocyanine green angiography, ICGA)及其中9例9只眼的光相干断层扫描(optical coherence tomography, OCT)检查的临床资料. 结果 11例11只眼诊断为PCV,分别占本组CNV患者71例142只眼的15.49%和7.75%.全部为单眼发病,其中男性7例,占63.6%,女性4例,占36.4%.年龄32～75岁,平均年龄62.3岁.检眼镜检查8只眼可见出血性或浆液性视网膜色素上皮脱离(retinal pigment epithelial detachments,RPED),6只眼在黄斑区见结节样隆起病灶,9只眼视网膜下有出血,8只眼见脂质沉着.FFA检查显示脉络膜血管网及息肉样结构7只眼,早期呈边界清楚的强荧光,进行性渗漏,新生血管末梢膨大处出现点状强荧光.出血性RPED 4只眼,出血性同时有浆液性RPED 4只眼.ICGA检查11只眼均可见伞样或树枝样异常扩张的脉络膜血管网,以及血管网末梢多个息肉样膨大,与检眼镜眼底检查所见的结节样病变部位吻合.8只眼脉络膜血管网中心见滋养血管.OCT检查6只眼显示视网膜神经纤维层穹隆状隆起,视网膜色素上皮(retinal pigment epithelium,RPE)和脉络膜毛细血管光带可见结节样改变.3只眼见单纯RPED,5只眼见RPED合并神经上皮脱离.10只眼病变部位位于黄斑区,占90.9%,1只眼病变位于视盘颞侧,占9.1%. 结论 PCV好发于老年男性患者,单眼发病为主.多在黄斑区出现出血性或浆液性RPED及脂质沉着,ICGA可见特征性的伞样或树枝样异常扩张的脉络膜血管网及末梢息肉样膨大病灶.
- [1]张承芬.眼底病学[M].1998.
- [2]闫宏,易长贤,胡兆科,等.中心性渗出性脉络膜视网膜病变的眼底荧光血管造影与吲哚青绿血管造影对比分析[J].1999,(3).
- [3]Yannuzzi Lawrence A..The Expanding Clinical Spectrum of Idiopathic Polypoidal Choroidal Vasculopathy[J].1997.
- [4]H, Iijima,T, Iida,M, Imai,etc.Optical coherence tomography of orange-red subretinal lesions in eyes with idiopathic polypoidal choroidal vasculopathy.[J].2000,129(1).
- [5]Hiroyuki Iijima,Masahito Imai,Takashi Gohdo,etc.Optical coherence tomography of idiopathic polypoidal choroidal vasculopathy[J].1999,127(3).
- [6]B T, Perkovich,Z N, Zakov,L A, Berlin,etc.An update on multiple recurrent serosanguineous retinal pigment epithelial detachments in black women.[J].1990,10.
- [7]主编吴德正.眼部吲哚菁绿血管造影学[M].2002.
- [8]Uyama,M,Matsubara,T,Fukushima,I,etc.Idiopathic polypoidal choroidal vasculopathy in Japanese patients.[J].1999,117(8).
- [9]Spaide RF,Yannuzzi LA,Moorthy RS,etc.Idiopathic polypoidal choroidal vasculopathy of the macula.[J].1998,105(8).