息肉状脉络膜血管病变42例临床特征研究  

The clinical characteristic of polypoidal choroidal vasculopathy

作　　者：乔瑛[1] 陈承[1] 武炳慧[1] 陆慧琴[1] QIAO Ying;CHEN Cheng;WU Binghui(Department of Ophthalmology,Xi’an No.1 Hospital(Xi’an 710002))

机构地区：[1]西安市第一医院眼科,西安710002

出　　处：《陕西医学杂志》2019年第5期632-635,共4页Shaanxi Medical Journal

摘　　要：目的:观察息肉状脉络膜血管病变(PCV)的眼底、造影表现、光学相干断层扫描(OCT)特征及对玻璃体腔注射抗VEGF(雷珠单抗)药物后的治疗反应。方法:取经荧光素眼底血管造影(FFA)、吲哚氰绿造影(ICGA)及OCT确诊的42例(42只眼)PCV患者,观察PCV患者的眼底、造影及OCT的表现,并对这42只眼行玻璃体腔注射抗VEGF药物,每月1次,连续3次,观察患者最佳矫正视力(BCVA)的变化,OCT测量黄斑中心凹厚度(CRT)的变化,脂状突起及双层征的变化。结果:PCV患者视网膜下出血、橘红色病灶及脂质沉着为眼底镜下特征性表现;息肉(Polyps)及脉络膜异常分枝血管网(BVN)为ICGA的影像特征;脂状突起,双层征为OCT的影像特征。抗VEGF治疗3个月,患者的BCVA多数有改善;所有患者的CRT均较治疗前降低,部分患者脂状突起及双层征消退。结论:PCV有其特征性的眼底、ICGA和OCT特征,通过对这些特征的把握可更好的诊断PCV;玻璃体腔注射抗VEGF药物对PCV的治疗有明确的效果,可做为治疗方法之一。Objective:To investigate the clinical features of polypoidal choroidal vasculopathy(PCV)in fundus fluorescein angiography(FFA),indocyanine green angiography(ICGA),optical coherence tomography(OCT)and the efficiency of intravitreal ranibizumab therapy for polypoidal choroidal vasculopathy.Methods:42 patients(42 eyes)confirmed by fundus examination,FFA,ICGA and OCT were diagnosed PCV,the lesions were located in macular area.Observed the characteristic of FFA,ICGA and OCT of PCV.All patients received intravitreal ranibizumab once a month,a total of three times.Observed the change of the best corrected visual acuity(BCVA),OCT measure the central retinal thickness(CRT),the changes of retinal pigment epithelium serration and the doubleline symptom.Results:Underretinal hemorrhage,orange nodular lesion and lipidosis were the characteristic ocular fundus changes;Polyps and branching vascular networks(BVN)were the characteristic of ICGA image;Retinal pigment epithelium serration and doubleline symptom were the characteristic of OCT image.3 months after anti-VEGF treatment,the best corrected visual acuity(BCVA)almost improved;all patients’CRT were decreased then prior treatment.Some of the eyes existd retinal pigment epithelium serration and doubleline symptom were partial disappeard after treatment.Conclusion:PCV has its ICGA and OCT imaging features and characteristic clinical feature.These features can help us make the right diagnosis.Anti-VEGF drugs have a definite effect on the treatment of PCV which can be used as one of the methods to treat PCV.

关 键 词：息肉状脉络膜血管病变 吲哚青绿血管造影 相干光学断层扫描 抗VEGF治疗 最佳矫正视力 黄斑中心凹厚度 

分 类 号：R773.4[医药卫生—眼科]