渗出型老年性黄斑变性与息肉状脉络膜血管病变眼底形态学的对比分析  

Characteristics of the ocular fundus of exudative age-related macular degeneration and polypoidal choroidal vasculopathy

作　　者：文峰[1] 吴德正[1] 陈艳丽[1] 孙祖华[1] 黄时洲[1] 罗光伟[1] 关天芹[1] 刘彩娇[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《中华眼底病杂志》2004年第5期307-309,共3页Chinese Journal of Ocular Fundus Diseases

基　　金：国家自然科学基金资助项目 (30 2 71 669) ;广东省中医药局科研基金资助项目 (1 0 30 59)

摘　　要：目的　观察渗出型老年性黄斑变性 (AMD)与息肉状脉络膜血管病变 (PCV)眼底表现的异同。　方法　回顾性分析渗出型 AMD患者 12 3例 137只眼及 PCV患者 4 2例 4 8只眼的眼底彩色像、荧光素眼底血管造影 (FFA)和吲哚青绿血管造影 (ICGA)检查资料。　结果　 137只渗出型 AMD患眼中 ,FFA显示 16只眼为典型脉络膜新生血管 (CNV) ,占 11.7% ;隐匿型 CNV12 1只眼 ,占 88.3%。隐匿型 CNV患眼中 ,4 2只眼 ICGA检查可见“热点状”(hot spots)荧光 ,占 34.7% ;74只眼表现为后期斑状强荧光 ,占6 1.2 % ;2只眼 CNV与 PCV共存 ,占 1.7%。 4 8只 PCV眼中 ,7只眼的眼底彩色像可见特有的视网膜下橘红色结节样病灶 ,占 14 .6 % ;2只眼 FFA即显示出分支状脉络膜血管网及息肉状病灶 ,占 4 .2 % ;36只眼ICGA显示异常分支的脉络膜血管网及其末梢的息肉状扩张灶 ,占 75 .0 % ;12只眼 ICGA显示多个息肉状扩张灶而未见伴有分支状脉络膜血管网 ,占 2 5 .0 %。息肉状病灶呈葡萄串样外观者 16只眼 ,占 33.3% ;,呈多个孤立并存者 32只眼 ,占 6 6 .7%。造影后期部分息肉状病灶染料渗漏或染色 ,部分呈息肉状病灶中心为弱荧光 ,周围环状染色的“冲刷现象”。　结论　渗出型 AMD与 PCV不同的 ICGA表现及Objective To compare the characteristics of the ocular fundus of exudative age-related macular degeneration (AMD) with polypoidal choroidal vasculopathy (PCV). Methods The photographs of ocular fundus of 123 patients (137 eyes) with exudative AMD and 42 patients (48 eyes) with PCV diagnosed by fundus photography, fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA) were retrospectively analyzed. Results In 137 eyes with exudative AMD, 16 eyes (11.7%) had classic neovascularization (CNV), 121 (88.3%) had occult CNV. In the eyes with occult CNV, 42 eyes (34.7%) had hot spots, 74 eyes (61.2%) showed plaque hyperfluorescences and 2 eyes (1.7%) had hot spots with PCV in ICGA. In 48 eyes with PCV, 7 eyes (14.6%) had subretinal reddish-orange lesions, 2 eyes (4.2%) of the polypoidal dilations with branching vascular network were detected with FFA, 36 eyes (75.0%) demonstrated polypoidal dilations with branching vascular network, and 12 eyes (25.0%) showed scattered polypoidal dilations without identifiable continuous branching vascular network, 16 eyes (33.3%) had the polypoidal dilations resembling a cluster of grapes, and 32 eyes (66.3%) showed the polypoidal dilations as several solitary round aneurismal dilations. The polypoidal dilations showed either a washout of the dye from the polyp with staining of its walls or staining of the dye in the late phase of ICGA. Conclusions The different features of exudative AMD and PCV in the ICGA, and the PCV with subretinal reddish-orange lesions are useful in the differentiate diagnosis of the both diseases.

关 键 词：息肉 脉络膜 病灶 眼底 ICGA 渗出 CNV 

分 类 号：R774.5[医药卫生—眼科]