黄斑中心凹旁渗出性血管异常复合体的临床特征观察  

Clinical features of parafoveal exudative vascular anomalous complex

作　　者：肖媛媛[1] 李毅斌[1] 刘广峰 彭晓燕[1] Xiao Yuanyuan;Li Yibin;Liu Guangfeng;Peng Xiaoyan(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Key Laboratory of Ophthalmology&Visual Science,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院、北京同仁眼科中心眼科学与视觉科学北京市重点实验室,100730

出　　处：《眼科》2022年第6期458-462,共5页Ophthalmology in China

摘　　要：目的总结黄斑中心凹旁渗出性血管异常复合体的临床特征。设计回顾性病例系列。研究对象2014-2022年北京同仁医院黄斑中心凹旁渗出性血管异常复合体患者12例(12眼)。方法所有患者均行最佳矫正视力(BCVA)、裂隙灯显微镜、间接检眼镜、彩色眼底照相、相干光断层扫描(OCT)、相干光断层扫描血流成像(OCTA)、荧光素眼底血管造影(FFA)等检查。随访2~72个月,平均[8(5,35)]个月。主要指标眼底表现,OCT、OCTA及FFA表现。结果患者平均年龄(57±13)岁。12例患者均为单眼发病,6眼(50.0%)伴硬性渗出,6眼(50.0%)伴黄斑囊样水肿,1眼(8.3%)伴中心凹旁出血。黄斑中心凹视网膜厚度(197~422)μm,平均[218(210,286)]μm。异常微血管瘤中心距黄斑中心凹水平距离(241~843)μm,平均(527±205)μm,其中<500μm者7眼(58.3%)。12例患者均为黄斑中心凹旁孤立的微血管扩张,管腔直径(84~329)μm,平均[113(96,119)]μm。9眼(75.0%)异常微血管瘤位于视网膜毛细血管深层。2眼行玻璃体抗血管内皮生长因子注射治疗,注射后1眼加重;1眼连续两次注射无应答后行微脉冲激光治疗,1个月后囊样水肿减轻。1眼黄斑囊样水肿自行消退,异常微血管瘤仍存在;1眼管腔逐渐扩张。1眼合并慢性闭角型青光眼。结论黄斑中心凹旁渗出性血管异常复合体表现为黄斑中心凹旁孤立的微血管瘤样扩张,多位于视网膜深层毛细血管网;黄斑水肿可自行消退,微血管瘤可自行消退或逐渐扩张。Objective To summarize the clinical features of parafoveal exudative vascular anomalous complex(PEVAC).Design Retrospective case series.Participants Twelve eyes of 12 patients with PEVAC in Beijing Tongren Hospital from 2014 to 2022.Methods The clinical data and medical records of the enrolled patients were collected,including best-corrected visual acuity(BCVA),slit-lamp examination,ophthalmoscopy,color fundus photograph(CFP),optical coherence tomography(OCT),OCT angiography(OCTA),fundus fluorescence angiography(FFA).Main Outcome Measures Findings and manifestations on CFP,OCT,OCTA and FFA.Results Twelve patients were all subjected to monocular onset,with a mean age of(57±13)years old.The follow-up period ranged from 2 to 72 months,with an average of[8(5,35)]months.Hard exudation and cystoid macular edema(CME)were respectively seen in 6 patients(50%),and only 1 patient(8.3%)was accompanied with parafoveal hemorrhage.The foveal retinal thickness was 197 to 422μm with an average of[218(210,286)]μm.The horizontal distance of the aneurysmal lesion to the central fovea ranged from 241 to 843μm with an average of(527±205)μm,whereas horizontal distances to the fovea in 7 patients(58.3%)were less than 500μm.All the patients suffered from the parafoveal isolated aneurysmal lesion with a mean diameter of[113(96,119)]μm ranging from 84 to 329μm.The aneurysmal lesion of 9 patients(75.0%)were located at deep retinal capillaries.Two patients underwent intravitreal anti-vascular endothelial growth factor(anti-VEGF)injection treatment,of which 1 patient was aggravated after intravitreal anti-VEGF.One patient was subjected to a micropulse laser treatment due to the failure of twice continuous intravitreal injection,and CME was relieved 1 month after giving a micropulse lasertreatment.Besides,the CME of another patient spontaneously subsided during follow-up,however,the diameter of the aneurysmal lesion in one patient was gradually dilatated.One patient was complicated with chronic angle closure glaucoma.Conclusions PEVAC

关 键 词：黄斑中心凹旁渗出性血管异常复合体 相干光断层扫描血流成像 微脉冲激光光凝 

分 类 号：R774.5[医药卫生—眼科]