息肉状脉络膜血管病变的吲哚菁绿眼底血管造影分型研究  

Angiographic classification of polypoidal lesions in polypoidal choroidal vasculopathy on indocyanine green angiography

作　　者：左成果[1] 文峰[1] 黄时洲[1] 罗光伟[1] 阎宏[1] 李猛[1] 陈卉[1] 

机构地区：[1]眼科学国家重点实验室,中山大学中山眼科中心,广州510060

出　　处：《中国实用眼科杂志》2010年第5期479-483,共5页Chinese Journal of Practical Ophthalmology

基　　金：国家重点基础研究发展计划（973计划2007CB512206）

摘　　要：目的 分析黄斑区息肉状脉络膜血管病变（PCV）在吲哚菁绿眼底血管造影（ICGA）中的不同渗漏亚型及临床特点.方法 对经荧光素眼底血管造影（FFA）及ICGA确诊为PCV的137例144只患眼进行ICGA渗漏状态的分型及各型临床特点的分析.结果 在144只PCV患眼的ICGA中,110只眼出现晚期染料渗漏（渗漏型,76%）.渗漏型又可分为三个亚型：息肉灶渗漏型（47只眼,42.7%）、异常分支状脉络膜血管渗漏型（14只眼,12.7%）和混合渗漏型（49只眼,44.5%）.其他34只眼显示出晚期病灶的消退和（或）呈冲刷现象（消退型,24%）.在渗漏型中,色素上皮脱离（PED）、最佳矫正视力（BCVA）〈0.1及陈旧性视网膜下出血的比例分别为56.4%（62只眼）,19.1%（21只眼）和4.6%（5只眼）;消退型相应比例分别为8.8%（3只眼）、50%（17只眼）和38.2%（13只眼）（P〈0.001）,同时消退型的病程显著长于渗漏型（P〈0.001）.结论 在ICGA中可以观察PCV病灶的晚期渗漏及消退现象,其中以渗漏型居多.混合性渗漏是渗漏型中最常见的亚型.渗漏型多表现PED,较好的BCVA以及较短的病程,而消退型则更易表现视网膜下陈旧性出血、较差的BCVA以及较长的病程.这可能提示前者为活动性病灶或处于疾病的早期阶段,而后者则为静止性病灶或处于疾病的晚期阶段.Objective To investigate the angiographic classification of polypoidal lesions in polypoidal choroidal vasculopathy （PCV） on indocyanine green angiography （ICGA）. Methods One hundred and forty four eyes of 137 patients diagnosed as PCV were prospectively observed. Fundus examination, color fundus photography and ICGA were performed. Angiographic classification of polypoidal lesions and clinical features were recorded. Results In all 144 eyes, 110 eyes showed angiographic leakage （leakage group, 76%） on ICGA and three subtypes of the leakage group were noted, which were polypoidal dilations leakage （47 eyes, 42.7%）, branching vascular networks leakage （14 eyes, 12.7%） and leakage of both （49 eyes, 44.5%）. The other 34 eyes showed regression of polypoidal lesions （regression group, 24%）. In leakage group, the rates of pigment epithelial detachment （PED）, best corrected visual acuity （BCVA） 〈0.1 and old subretinal hemorrhages were respectively 56.4% （62 eyes）, 19.1% （21 eyes）, and 4.6% （5 eyes）, compared with 8.8% （3 eyes）, 50% （17 eyes） and 38.2% （13 eyes） for regression group （P〈0.001）. The history of regression group was significantly longer （P〈0.001）. Conclusions Angiographic leakage and regression can be observed in PCV lesions. Leakage of both polypoidal dilations and branching vascular networks is the most common subtype in leakage group. PCV in leakage group is more likely to be related to PED, better BCVA and shorter history, while PCV in regression group tends to relevant to old subretinal hemorrhage, worse BCVA and longer history. This may reflect the former is active or in the early course while the latter is resting or in the late phase of PCV.

关 键 词：息肉状脉络膜血管病变 吲哚菁绿血管造影 荧光素眼底血管造影 

分 类 号：R773.4[医药卫生—眼科]