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ENGLISH ABSTRACT
病理性近视继发脉络膜新生血管诊疗现状与进展
占宗议
李梓敬
丁小燕
作者及单位信息
·
DOI： 10.3760/cma.j.issn.1005-1015.2016.01.029
Choroidal neovascularization secondary to pathologic myopia: a recent update on diagnosis and treatment
Zhan Zongyi
Li Zijing
Ding Xiaoyan
Authors Info & Affiliations
Zhan Zongyi
Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
Li Zijing
Ding Xiaoyan
·
DOI： 10.3760/cma.j.issn.1005-1015.2016.01.029
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摘要

病理性近视继发脉络膜新生血管(PM-CNV)的危险因素包括老龄、眼轴长、中心凹下脉络膜厚度薄、患眼有萎缩斑或漆裂纹，其发病机制可能与这些因素引起的视网膜色素上皮萎缩或缺氧导致外层视网膜分泌血管内皮生长因子(VEGF)有关。荧光素眼底血管造影检查可提示PM-CNV病灶类型、位置和活动性。光相干断层扫描检查可见活动期PM-CNV表现为紧临视网膜色素上皮的强反射区域伴极少量视网膜下积液；瘢痕期表现为病灶表面强反射，伴下方信号快速衰减；萎缩期则表现为平坦退化病灶和脉络膜视网膜萎缩。光动力疗法与抗VEGF药物玻璃体腔注射是目前治疗PM-CNV的主要方法。其中，抗VEGF药物玻璃体腔注射为目前更多推崇关注的治疗方法。但其治疗频率、再治疗及终止治疗标准等具体用药方案以及治疗效果的影响因素均需更多大样本随机对照研究进一步观察探讨。

脉络膜新生血管化/诊断;脉络膜新生血管化/治疗;近视，退行性/并发症;综述
ABSTRACT

Pathological myopia can induce choroidal neovascularization (PM-CNV). The potential risk factors include ageing, long axial length of the eyeball, thinning of subfoveal choroidal thickness, fundus atrophy spot and lacquer crack. These factors may induce atrophy of retinal pigment epithelial cells (RPE) and hypoxia, resulting in vascular endothelial growth factors (VEGF) secretion by outer retina. The lesion type, location and activity of PM-CNV can be determined by fundus fluorescein angiography. The features of PM-CNV on optical coherence tomography include strong reflective area close to RPE with very small amount of subretinal fluid (active stage), surface strong reflection with signal attenuation area (scar stage) and flat lesion and chorioretinal atrophy (atrophy stage). Photodynamic therapy and intravitreal injection of anti-VEGF drugs are major treatments for PM-CNV, the latter is more commonly used now. However, more large randomized controlled studies are required to explore the treatment regimen (such as frequency, indications for repeated or termination of treatment) and the efficacy factors further.

Choroidal neovascularization/diagnosis;Choroidal neovascularization/therapy;Myopia, degenerative/complications;Review
Ding Xiaoyan, Email: mocdef.labiamg57yxgniD
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引用本文

占宗议,李梓敬,丁小燕. 病理性近视继发脉络膜新生血管诊疗现状与进展[J]. 中华眼底病杂志,2016,32(1)：104-107.

DOI:10.3760/cma.j.issn.1005-1015.2016.01.029

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病理性近视(PM)指高度近视伴眼底病理性改变，人群患病率约0.9%～3.1%，而其中发生脉络膜新生血管(CNV)者约占5.2%～11.3% [ 1 ， 2 ]。PM继发CNV(PM-CNV)是造成患者视力损失的重要原因之一，预后较差。目前主要治疗方法是光动力疗法(PDT)与抗血管内皮生长因子(VEGF)药物治疗。其中，抗VEGF药物治疗已有较多小样本临床观察证实其有效性与安全性，但对其治疗方案、再治疗标准、随访方案等仍有争议。现就PM-CNV的诊疗现状与进展作一综述。
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