中华眼底病杂志

中华眼底病杂志

254例息肉样脉络膜血管病变的临床特征分析

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目的 观察息肉样脉络膜血管病变 ( PCV)的临床特征。方法 回顾性分析254例临床确诊的PCV患者306只眼的临床资料。所有患者均行矫正视力、裂隙灯显微镜、间接检眼镜、眼底彩色照相、荧光素眼底血管造影、吲哚青绿血管造影以及光相干断层扫描检查(O CT)。结果 254例患者中,男性152例,占59.8%;女性102例,占40.2%。年龄38~91岁,平均年龄(65.4plusmn;8.9)岁。双眼52例,占20.5%;单眼202例,占79.5%。患眼矫正视力无光感~1.2。其中,矫正视力<0.1者167只眼,占54.6%;ge;0.1且<0.3者92只眼,占30.1%;ge;0.3者47只眼,占15.4%。有玻璃体积血61只眼,占19.9%。202例单眼PCV患者中,另眼可见玻璃膜疣68例,占33.7%;渗出型老年性黄斑变性2例,占11.9%;对侧眼有中心性浆液性脉络膜视网膜病变病史9例,占4.5%。306只眼中,可见脉络膜高通透性表现43只眼,占14.1%。PCV病变位于黄斑区下199只眼,占65.0%;颞侧视网膜血管弓下49只眼,占16.0%;视盘旁15只眼,占4.9%。形态表为孤立样110只眼,占35.9%;簇样176只眼,占57.5%;串样3只眼,占1.0%;分支样4只眼,占1.3%;既有孤立样同时也有簇样13只眼,占4.2%。存在神经视网膜下液性暗区125只眼,占40.8%;出血性视网膜色素上皮脱离121只眼,占39.5%;浆液性视网膜色素上皮脱离73 只眼,占22.9%。结论 PCV双眼发病率、女性患病比例较高;病灶位于视盘旁比例较低。

Objective To observe the clinical characteristics of polypoidal choroidal vasculopathy (PCV). Methods Two hundreds fifty-four PCV patients (306 eyes) were enrolled in this study. All the patients were examined for corrected visual acuity (BCVA) testing, slit-lamp microscope, indirect ophthalmoscopy, fundus photography, fluorescein angiography, indocyanine green angiography and optic coherence tomography. Results The patients included 152 males (59.8%) and 102 females (40.2%); the age was from 38 to 91 years, with a mean age of (65.4plusmn;8.9) years. Bilateral lesions were observed in 52 patients (20.5%) and unilateral lesions were observed in 202 patients (79.5%). BCVA varied from non-light perception to 1.2. BCVA was lower than <0.1 in 167 eyes (54.6%), ge;0.1 but <0.3 in 92 eyes (30.1%) and ge;0.3 in 47 eyes (15.4%). Vitreous hemorrhage was observed in 61 eyes (19.9%). In 202 patients with unilateral PCV lesions, drusen can be observed in the contralateral eyes of 68 patients (33.7%), exudative agerelated macular degeneration changes in the contralateral eyes of 24 patients (11.9%), and central serous chorioretinopathy history was positive in the contralateral eyes in nine patients (4.5%). In 306 eyes, there were 43 eyes (14.1%) with high permeable choroid. PCV lesions located at macula area in 199 eyes (65.0%), under the temporal retinal vascular arcade in 49 eyes (16.0%), and peripapillary in 15 eyes (4.9%). PCV lesion formation was single in 110 eyes (35.9%), cluster in 176 eyes (57.5%), string in three eyes (1.0%), branch in four eyes (1.3%), and both single and cluster polyps in 13 eyes (4.2%). There were 125 eyes (40.8%) with sub-neuroretinal fluid, 121 eyes (39.5%) with hemorrhagic pigment epithelium detachment, and 73 eyes (22.9%) with serous pigment epithelium detachment. Conclusion PCV patients have higher bilateral incidence and female prevalence, and lower rate of peripapillary lesions.

关键词: 脉络膜疾病; 黄斑变性; 疾病特征

Key words: Choroid ; diseases; Macular ; degeneration; Disease ; attributes

引用本文: 陶勇,侯婧,黎晓新. 254例息肉样脉络膜血管病变的临床特征分析. 中华眼底病杂志, 2012, 28(5): 441-444. doi: 复制

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