急性渗出性多形性卵黄样黄斑病变临床研究进展  

Clinical research progress on acute exudative polymorphous vitelliform maculopathy

作　　者：蒋莉(综述) 杨明明(审校) JIANG Li;YANG Mingming(Department of Ophthalmology,Shenzhen People’s Hospital,Second Clinical Medical College of Jinan University,the First Affiliated Hospital,Southern University of Science and Technology,Shenzhen 518020,China)

机构地区：[1]深圳市人民医院眼科,暨南大学第二临床医学院,南方科技大学第一附属医院,深圳518020

出　　处：《眼科学报》2025年第2期171-178,共8页Eye Science

基　　金：深圳市科技创新委员会基础研究面上项目(JCYJ20230807111900002)。

摘　　要：急性渗出性多形性卵黄样黄斑病变(acute exudative polymorphous vitelliform maculopathy, AEPVM)是一种在临床较为罕见的眼底疾病,主要表现为黄斑区神经上皮脱离以及后极部卵黄样物质的沉积。至今,其具体发病机制仍未完全明确,但可能与全身感染、自身免疫反应或副肿瘤综合征等因素密切相关。在临床表现上,患者往往会出现轻微视力减退或畏光等症状,眼底后极部可见斑点状黄白色病灶,这些病灶在自发荧光中呈现相对较高的自发荧光。荧光素眼底血管造影时,病灶区域通常不会出现荧光素渗漏现象。OCT检查能够揭示椭圆体带的显著增厚以及神经上皮层内囊腔样改变。迄今为止,对于这一疾病的治疗尚未有确立的方案。文章综述了AEPVM的临床表现、影像学特征、诊断及鉴别诊断、发病机制以及治疗方面的最新研究进展。急性渗出性多形性卵黄样黄斑病变的自然病程复杂多样,其诊断与鉴别诊断仍面临重大挑战,深入掌握该疾病的临床表现与影像学特征,对于未来深化对其发病机制的理解及开发有效治疗策略具有重要意义。Acute Exudative Polymorphous Vitelliform Maculopathy(AEPVM)is a clinically rare fundus disease characterized primarily by neurosensory detachment in the macular area and accumulation of vitelliform material in the posterior pole.The exact cause is unclear and may be related to systemic infections,autoimmune responses,or paraneoplastic syndromes.Clinical manifestations usually include mild vision loss or photophobia,and yellow-white deposits can be seen in the posterior pole of the fundus,exhibiting relatively higher autofluorescence in spontaneous fluorescence.Fundus fluorescein angiography typically does not show leakage of fluorescein in the lesion area.Optical coherence tomography(OCT)examination can reveal thickening of the ellipsoid zone and cystic changes within the neurosensory layer.Currently,there is no explicit treatment plan.This article reviews the clinical presentation,imaging characteristics,diagnosis and differential diagnosis,pathogenesis,and treatment-related research progress of acute exudative polymorphous vitelliform maculopathy.In summary,the natural course of acute exudative polymorphous vitelliform maculopathy is complex and diverse,and its diagnosis and differential diagnosis remain challenging.A deeper understanding of the clinical presentations and imaging characteristics of acute exudative polymorphous vitelliform maculopathy will facilitate further research and exploration to clarify its pathological mechanisms and identify effective treatment methods in the future.

关 键 词：急性渗出性多形性卵黄样黄斑病变 卵黄样病变 视网膜神经上皮脱离 

分 类 号：R774.5[医药卫生—眼科] R770.4[医药卫生—临床医学]