息肉样脉络膜血管病变的临床特征分析

发布时间：2018-07-15 22:45

【摘要】：目的观察息肉样脉络膜血管病变（polypoidal choroidal vasculopathy，PCV）的临床特征。方法回顾分析我院自2008年7月～2012年4月确诊为PCV的174例（206眼）患者的眼底彩色照相（fundus photography，FP）、荧光素眼底血管造影（fundusfluorescein angiography，FFA）、吲哚青绿脉络膜血管造影(indocyanine greenangiography, ICGA)和相干光断层成像（optical coherence tomography，OCT）。结果 1.眼底检查发现：橘红色病灶146眼（70.9%）；视网膜出血79眼（38.3%）；硬性渗出71眼(34.5%)；玻璃膜疣8眼（3.9%）。 2.FFA检查发现：144眼（70.0%）早期见密度不均的斑点状强荧光，晚期呈强度不均的强荧光斑片；49眼（23.8%）表现为大片遮蔽荧光；色素上皮脱离为99眼(48.1%)。 3.ICGA检查发现：息肉样高荧光位于黄斑区149眼（72.3%），视盘区20眼（9.7%），，血管弓区19眼（9.2%）;18眼位于混合区(8.7%),其中黄斑区+视盘区4眼(1.9%),黄斑区+血管弓区10眼(4.9%),视盘区+血管弓区4眼(1.9%)。息肉样病灶呈孤立样17眼（8.3%），呈簇样189眼（91.7%）；脉络膜异常分支血管网149眼（72.3%）；晚期地图样高荧光110眼（53.4%）。 4.OCT检查发现：PCV的异常分支血管网表现为视网膜色素上皮层呈扁平波纹状隆起，RPE层与Bruch’s膜之间可见中至高的反射信号68眼（41.5%）；PCV的异常分支血管网表现为RPE层较高隆起，其下可见中高反射和(或)出血（浆液）信号64眼(39.0%)。结论 PCV以视网膜下橘红色病灶为其眼底特征;FFA造影早期见密度不均的斑点状强荧光，晚期呈强度不均的斑驳状强荧光斑片，浆液性或出血性色素上皮脱离多见;ICGA造影表现为息肉样高荧光，脉络膜异常分支血管和晚期地图样高荧光，息肉样病灶多位于黄斑部;PCV的异常分支血管网OCT表现为视网膜色素上皮层和Bruch’s膜之间的中高反射信号。
[Abstract]:Objective to observe the clinical features of polypoid choroidal angiopathy (polypoidal choroidal). Methods from July 2008 to April 2012, 174 patients (206eyes) with PCV diagnosed in our hospital were analyzed retrospectively, including fundus photography (FP), fundusfluorescein angiography (FFA), indocyanine green choroidal angiography (indocyanine greenangiography, ICGA), and Coherence tomography (Oct). Result 1. Fundus examination revealed orange lesions in 146 eyes (70.9%), retinal hemorrhage in 79 eyes (38.3%), rigid exudation in 71 eyes (34.5%), vitreous verruca in 8 eyes (3.9%). 49 eyes (23.8%) with intensity uneven in the late stage showed large obscured fluorescence. 3.The polypoid hyperfluorescence was found in 149 eyes (72.3%) in macular area, 20 eyes (9.7%) in optic disc area, and 19 eyes (9.2%) in vascular arch area in mixed area (8.7%). 4 eyes (1.9%) were located in macular area, 4 eyes (1.9%) in macular area and 19 eyes (9.2%) in vascular arch area. Vascular arch in 10 eyes (4.9%) and optic disc in 4 eyes (1.9%). 17 eyes (8.3%) were solitary, 189 eyes (91.7%) were cluster like, 149 eyes (72.3%) were abnormal choroidal branch vascular network. (4) the abnormal branch vascular network of 1: PCV was found in 68 eyes (41.5%) with moderate and high reflectance between the RPE layer of retinal pigment epithelium and the Bruchus membrane, and the abnormal branch vascular network was found in 68 eyes (41.5%). The abnormal branch vascular network of PCV showed a higher bulge of RPE layer, which showed moderate hyperreflex and / or hemorrhage signal in 64 eyes (39.0%). Conclusion the fundus feature of PCV is subretinal orange-red focus. FFA imaging shows that the density is uneven in the early stage, and the intensity is uneven in the late stage. In serous or hemorrhagic pigment epithelium detachment, ICGA showed polypoid hyperfluorescence, choroidal abnormal branching vessels and late map hyperfluorescence. Most of the polypoid lesions were located in the abnormal branch of macular PCV. Oct showed the middle and high reflex signal between the retinal pigment epithelium and the Bruchus membrane.
【学位授予单位】：济南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R773.4

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