目的 观察息肉样脉络膜血管病变(PCV)的临床特征.方法 回顾性分析254例临床确诊的PCV患者306只眼的临床资料.所有患者均行矫正视力、裂隙灯显微镜、间接检眼镜、眼底彩色照相、荧光素眼底血管造影、吲哚青绿血管造影以及光相干断层扫描检查(OCT).结果 254例患者中,男性152例,占59.8%;女性102例,占40.2%.年龄38~91岁,平均年龄(65.4±8.9)岁.双眼52例,占20.5%;单眼202例,占79.5%.患眼矫正视力无光感~1.2.其中,矫正视力<0.1者167只眼,占54.6%;≥0.1且<0.3者92只眼,占30.1%;≥0.3者47只眼,占15.4%.有玻璃体积血61只眼,占19.9%.202例单眼PCV患者中,另眼可见玻璃膜疣68例,占33.7%;渗出型老年性黄斑变性24例,占11.9%;对侧眼有中心性浆液性脉络膜视网膜病变病史9例,占4.5%.306只眼中,可见脉络膜高通透性表现43只眼,占14.1%.PCV病变位于黄斑区下1 99只眼,占65.0%;颞侧视网膜血管弓下49只眼,占16.0%;视盘旁15只眼,占4.9%.形态表现为孤立样110只眼,占35.9%;簇样176只眼,占57.5%;串样3只眼,占1.0%;分支样4只眼,占1.3%;既有孤立样同时也有簇样13只眼,占4.2%.存在神经视网膜下液性暗区125只眼,占40.8%;出血性视网膜色素上皮脱离121只眼,占39.5%;浆液性视网膜色素上皮脱离73只眼,占22.9%.结论 PCV双眼发病率、女性患病比例较高;病灶位于视盘旁比例较低。
Objective To observe the clinical characteristics of polypoidal choroidal vasculopathy (PCV).Methods Two hundreds fifty-four PCV patients (306 eyes) were enrolled in this study.All the patients were examined for corrected visual acuity (BCVA) testing,slit-lamp microscope,indirect ophthalmoscopy,fundus photography,fluorescein angiography,indocyanine green angiography and optic coherence tomography.Results The patients included 152 males (59.8%) and 102 females (40.2%) ; the age was from 38 to 91 years,with a mean age of (65.4±8.9) years.Bilateral lesions were observed in 52 patients (20.5%) and unilateral lesions were observed in 202 patients (79.5%).BCVA varied from nonlight perception to 1.2.BCVA was lower than <0.1 in 167 eyes (54.6%),≥0.1 but <0.3 in 92 eyes(30.1%) and ≥0.3 in 47 eyes (15.4%).Vitreous hemorrhage was observed in 61 eyes (19.9%).In 202 patients with unilateral PCV lesions,drusen can be observed in the contralateral eyes of 68 patients (33.7%),exudative age-related macular degeneration changes in the contralateral eyes of 24 patients (11.9 %),and central serous chorioretinopathy history was positive in the contralateral eyes in nine patients (4.5%).In 306 eyes,there were 43 eyes (14.1%) with high permeable choroid.PCV lesions located at macula area in 199 eyes (65.0%),under the temporal retinal vascular arcade in 49 eyes (16.0%),and peripapillary in 15 eyes (4.9%).PCV lesion formation was single in 110 eyes (35.9%),cluster in 176 eyes (57.5%),string in three eyes (1.0%),branch in four eyes (1.3%),and both single and cluster polyps in 13 eyes (4.2%).There were 125 eyes (40.8%) with sub-neuroretinal fluid,121 eyes (39.5%) with hemorrhagic pigment epithelium detachment,and 73 eyes (22.9%) with serous pigment epithelium detachment.Conclusion PCV patients have higher bilateral incidence and female prevalence,and lower rate of peripapillary lesions.
陶勇,侯婧,黎晓新. 254例息肉样脉络膜血管病变的临床特征分析 : [J]. 中华眼底病杂志,2012,28(05):441-444.
DOI:10.3760/cma.j.issn.1005-1015.2012.05.003
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