渗出型老年性黄斑变性患者继发黄斑囊样水肿分析  

Cystoid macular edema 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299-302,共4页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的　探讨渗出型老年性黄斑变性 (AMD)患者继发黄斑囊样水肿 (CME)的原因。　方法　回顾性分析临床确诊的渗出型 AMD患者 14 0例 171只眼的光相干断层扫描 (OCT)检查结果 ,对其脉络膜新生血管 (CNV)进行分类 ,并分析其与 CME发生的关系。　结果　 171只 AMD患眼中 ,89只眼存在CME,占 5 2 .0 % ;82只眼无 CME,占 4 8.0 %。有 CME的患眼中 ,76只眼存在活动性 CNV病变 ,占85 .4 % ;13只眼已有盘状瘢痕形成 ,占 14 .6 %。无 CME的患眼中 ,6 9只眼存在活动性 CNV病变 ,占84 .1% ;13只眼有盘状瘢痕形成 ,占 15 .9%。有 CME且同时存在活动性 CNV病变的 76只患眼中 ,结合型CNV6 1只眼 ,占 80 .3% ;Gass2型 CNV14只眼 ,占 18.4 % ;Gass1型 CNV1只眼 ,占 1.3%。视网膜下CNV(结合型 +Gass2型 )占 98.7%。无 CME但有活动性 CNV的 6 9只患眼中 ,5 7只眼 CNV是位于视网膜色素上皮 (RPE)下的 Gass1型 ,占 82 .6 % ;12只眼为视网膜下 CNV,占 17.4 %。有无 CME两组之间视网膜下 CNV的发生率比较 ,其差异有显著性的意义 (χ2 =99.5 838,P=0 .0 0 0 0 )。　结论　 CME发生与CNV侵入视网膜感觉层下生长密切相关 ,视网膜下 CNV很可能是渗出型 AMD继发Objective To analyze the pathogenesis of cystoid macular edema (CME) secondary to exudative age-related macular degeneration (AMD). Methods From October 2000 to December 2003, OCT images of 171 eyes of 140 patients with exudative AMD were evaluated. The CNV types were classified according to its location (above or below the RPE), and the correlation between the types of CNV and the development of CME were analyzed. Results Of the 171 eyes with AMD, 89 eyes (52.0%) had CME, and 82 eyes (48.0%) had no CME. Among the 89 eyes with CME, 76 eyes (85.4%) had an active CNV lesion, and 13 eyes (14.6%) had a disciform scar. Among the 82 eyes without CME, 69 eyes (84.1%) had an active CNV lesion, and 13 eyes (15.9%) had a disciform scar. In the 76 eyes with both CME and active CNV, 75 eyes (98.7%) had a subretinal CNV, which included 61 eyes (80.3%)with a combined CNV complex and 14 eyes (18.4%) with a Gass 2 type CNV, only 1 eye (1.3%) had a Gass 1 type CNV. Whereas, in the 69 eyes with active CNV but without CME, 57 eyes (82.6%) had a Gass 1 type CNV, only 12 eyes (17.4%) had a subretinal CNV. There was a significant difference in the incidence of subretinal CNV between eyes with or without CME (χ~2=99.5838, P=0.0000). Conclusions CME formation was highly correlated with the invasion of CNV into the subretinal space. Subretinal CNV might be the direct cause of CME secondary to exudative AMD.

关 键 词：CNV CME 视网膜 渗出 患者 继发 黄斑囊样水肿 活动性 显著性 

分 类 号：R774.5[医药卫生—眼科]