渗出型老年性黄斑变性视网膜脉络膜血管吻合与视网膜色素上皮脱离的关系分析  

The correlation between retinal-choroidal anastomosis and pigment epithelium detachment secondary to exudative age-related macular degeneration

作　　者：姜荔[1] 马志中[2] 

机构地区：[1]解放军总医院眼科,北京100853 [2]北京大学第三医院眼科中心

出　　处：《中华眼底病杂志》2004年第5期295-298,共4页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的　探讨老年性黄斑变性 (AMD)视网膜脉络膜血管吻合 (RCA)与视网膜色素上皮脱离(PED)的关系。　方法　回顾分析 2 0 0 0年 10月～ 2 0 0 3年 12月诊治的渗出型 AMD患者 70例 75只眼的光相干断层扫描 (OCT)和眼底血管造影检查资料 ,观察有无 RCA形成以及与 PED发生的关系。　结果　75只渗出型 AMD患眼中 ,34只眼有 RCA形成 ,占 4 5 .3% ;4 1只眼未见 RCA,占 5 4 .7%。有 RCA形成同时存在 PED者 30只 ,占 88.2 % ;不伴有 PED者 4只眼 ,占 11.8%。无 RCA形成但存在 PED者 33只眼 ,占 80 .5 % ;不伴有 PED者 8只眼 ,占 19.5 %。有无 RCA形成的患眼 PED的发生率比较 ,差异无显著性的意义 (χ2 =0 .83,P=0 .5 2 90 )。无 RCA形成的 33只 PED患眼中 ,发生 PED裂孔者 17只眼 ,占 5 1.5 % ;有RCA形成的 30只 PED患眼中 ,发生 PED裂孔者 2 6只眼 ,占 86 .7% ,二者比较 ,差异有显著性的意义(χ2 =8.96 12 ,P=0 .0 0 30 )。　结论　 RCA形成在渗出型 AMD患眼中并不少见 ;RCA多与 PED并存 ,但两者之间无直接的因果关系 ;PED裂孔发生与 RCA形成密切相关。Objective To evaluate the correlation between retinal-choroidal anastomosis (RCA) and pigment epithelium detachment (PED) secondary to exudative age-related macular degeneration (AMD). Methods From October 2000 to December 2003, 75 eyes of 70 patients with active exudative AMD underwent OCT, fluorecein and/or indocyanine green angiography (FA/ICGA) examinations were analyzed to ascertain whether there was RCA. The correlations between RCA and PED were evaluated. Results Of 75 eyes with exudative AMD, 34 eyes (45.3%) had RCA, 41 eyes (54.7%) had no RCA. Among the eyes with RCA, 30 eyes (88.2%) had PED, the remaining 4 eyes (11.8%) had no PED. Among the eyes without RCA, 33 eyes (80.5%) had PED, and 8 eyes (19.5%) had no PED. There was no significant difference in the incidence of PED between eyes with or without RCA (χ~2=0.83, P=0.5290). PED tear was found in 17 eyes (51.5%)out of 33 eyes with PED and without RCA, but in 26 eyes (86.7%) out of 30 eyes with both PED and RCA. There was a significant difference in the incidence of PED tear between eyes with or without RCA (χ~2=8.9612, P=0.0030). Conclusions RCA is not uncommon in exudative AMD. It often coexisted with PED, but there is no direct correlation between them. PED tear is highly correlated with RCA formation.

关 键 词：渗出 视网膜色素上皮 RCA 裂孔 脉络膜 血管吻合 老年性黄斑变性 显著性 

分 类 号：R774.5[医药卫生—眼科]