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 agerelated 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.
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