中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2008年
9期
780-785
,共6页
史雪辉%魏文斌%田蓓%杨丽红%丁宁%王诏华%王光璐
史雪輝%魏文斌%田蓓%楊麗紅%丁寧%王詔華%王光璐
사설휘%위문빈%전배%양려홍%정저%왕조화%왕광로
脉络膜新生血管化%分类法%预后
脈絡膜新生血管化%分類法%預後
맥락막신생혈관화%분류법%예후
Choroidal neovascularization%Classification%Prognosis
目的 研究不同分类方法中脉络膜新生血管(CNV)的病变特征.方法 回顾性系列病例研究.收集2005年5月至2007年3月共312例(393只眼)CNV患者的临床资料,根据其CNV病因、荧光素眼底血管造影(FFA)和吲哚氰绿血管造影(ICGA)图像特征及病灶活动性进行分类,总结不同分类方法中CNV的病变特征.应用SPSS 10.0统计学软件进行数据分析.各病因组患者年龄间比较采用单因素多水平设计定量资料方差分析,各病因组患者性别差异采用列联表χ2检验.以P＜0.05作为差异有统计学意义.结果 CNV病因学分类:年龄相关性黄斑变性(AMD)CNV 153例(49.04%),特发性CNV 94例(30.13%),病理性近视CNV 37例(11.86%),炎性反应CNV 15例(4.81%),特发性息肉状脉络膜血管病变(PCV)CNV 7例(2.24%),血管样条纹CNV 3例(0.96%),遗传性、外伤性眼病及眼肿瘤性CNV各1例(0.32%).继发于AMD的CNV中男性99例(64.71%);而病理性近视、特发性CNV及炎性反应CNV中则以女性患者居多,分别为29例(78.38%)、69例(73.40%)、11例(73.33%).继发于AMD的CNV患者年龄49～95岁,平均(68.73±8.31)岁,50岁以上患者150例(98.04%);特发性CNV患者年龄13～43岁,平均(29.86±6.45)岁,其中20～40岁79例(84.04%).各病因组患者性别(χ2=57.17,P＜0.05)和年龄(F=172.57,P＜0.05)差异有统计学意义.FFA检查的分类结果中,AMD、PCV多为隐匿非典型性CNV(43.48%、66.67%),病理性近视、炎性反应和特发性CNV则多为完全典型性CNV(91.67%、76.19%及95.00%).各组中CNV均以黄斑中心凹下型为最多(58.00%～100.00%),其次为黄斑中心凹旁型(小于35.00%).依据ICGA中CNV形态,各病因组中CNV均以典型性表现为主.ICGA检查继发于AMD的CNV 54只眼中,隐匿性CNV(斑状、焦点状及混合性CNV)11只眼(20.37%),CNV瘢痕化17只眼(31.48%).各病因组中以活动性CNV为主.继发于AMD的CNV中,活动性CNV 33只眼(61.11%),静止性CNV 20只眼(37.04%),未显影1只眼(1.85%).结论 不同病因导致的CNV患者在年龄、性别及各分类中差别较大,FFA和ICGA图像特征与病灶活动性亦不相同.全面细致分类对CNV病因学诊断、综合治疗及判断预后有重要意义.
目的 研究不同分類方法中脈絡膜新生血管(CNV)的病變特徵.方法 迴顧性繫列病例研究.收集2005年5月至2007年3月共312例(393隻眼)CNV患者的臨床資料,根據其CNV病因、熒光素眼底血管造影(FFA)和吲哚氰綠血管造影(ICGA)圖像特徵及病竈活動性進行分類,總結不同分類方法中CNV的病變特徵.應用SPSS 10.0統計學軟件進行數據分析.各病因組患者年齡間比較採用單因素多水平設計定量資料方差分析,各病因組患者性彆差異採用列聯錶χ2檢驗.以P＜0.05作為差異有統計學意義.結果 CNV病因學分類:年齡相關性黃斑變性(AMD)CNV 153例(49.04%),特髮性CNV 94例(30.13%),病理性近視CNV 37例(11.86%),炎性反應CNV 15例(4.81%),特髮性息肉狀脈絡膜血管病變(PCV)CNV 7例(2.24%),血管樣條紋CNV 3例(0.96%),遺傳性、外傷性眼病及眼腫瘤性CNV各1例(0.32%).繼髮于AMD的CNV中男性99例(64.71%);而病理性近視、特髮性CNV及炎性反應CNV中則以女性患者居多,分彆為29例(78.38%)、69例(73.40%)、11例(73.33%).繼髮于AMD的CNV患者年齡49～95歲,平均(68.73±8.31)歲,50歲以上患者150例(98.04%);特髮性CNV患者年齡13～43歲,平均(29.86±6.45)歲,其中20～40歲79例(84.04%).各病因組患者性彆(χ2=57.17,P＜0.05)和年齡(F=172.57,P＜0.05)差異有統計學意義.FFA檢查的分類結果中,AMD、PCV多為隱匿非典型性CNV(43.48%、66.67%),病理性近視、炎性反應和特髮性CNV則多為完全典型性CNV(91.67%、76.19%及95.00%).各組中CNV均以黃斑中心凹下型為最多(58.00%～100.00%),其次為黃斑中心凹徬型(小于35.00%).依據ICGA中CNV形態,各病因組中CNV均以典型性錶現為主.ICGA檢查繼髮于AMD的CNV 54隻眼中,隱匿性CNV(斑狀、焦點狀及混閤性CNV)11隻眼(20.37%),CNV瘢痕化17隻眼(31.48%).各病因組中以活動性CNV為主.繼髮于AMD的CNV中,活動性CNV 33隻眼(61.11%),靜止性CNV 20隻眼(37.04%),未顯影1隻眼(1.85%).結論 不同病因導緻的CNV患者在年齡、性彆及各分類中差彆較大,FFA和ICGA圖像特徵與病竈活動性亦不相同.全麵細緻分類對CNV病因學診斷、綜閤治療及判斷預後有重要意義.
목적 연구불동분류방법중맥락막신생혈관(CNV)적병변특정.방법 회고성계렬병례연구.수집2005년5월지2007년3월공312례(393지안)CNV환자적림상자료,근거기CNV병인、형광소안저혈관조영(FFA)화신타청록혈관조영(ICGA)도상특정급병조활동성진행분류,총결불동분류방법중CNV적병변특정.응용SPSS 10.0통계학연건진행수거분석.각병인조환자년령간비교채용단인소다수평설계정량자료방차분석,각병인조환자성별차이채용렬련표χ2검험.이P＜0.05작위차이유통계학의의.결과 CNV병인학분류:년령상관성황반변성(AMD)CNV 153례(49.04%),특발성CNV 94례(30.13%),병이성근시CNV 37례(11.86%),염성반응CNV 15례(4.81%),특발성식육상맥락막혈관병변(PCV)CNV 7례(2.24%),혈관양조문CNV 3례(0.96%),유전성、외상성안병급안종류성CNV각1례(0.32%).계발우AMD적CNV중남성99례(64.71%);이병이성근시、특발성CNV급염성반응CNV중칙이녀성환자거다,분별위29례(78.38%)、69례(73.40%)、11례(73.33%).계발우AMD적CNV환자년령49～95세,평균(68.73±8.31)세,50세이상환자150례(98.04%);특발성CNV환자년령13～43세,평균(29.86±6.45)세,기중20～40세79례(84.04%).각병인조환자성별(χ2=57.17,P＜0.05)화년령(F=172.57,P＜0.05)차이유통계학의의.FFA검사적분류결과중,AMD、PCV다위은닉비전형성CNV(43.48%、66.67%),병이성근시、염성반응화특발성CNV칙다위완전전형성CNV(91.67%、76.19%급95.00%).각조중CNV균이황반중심요하형위최다(58.00%～100.00%),기차위황반중심요방형(소우35.00%).의거ICGA중CNV형태,각병인조중CNV균이전형성표현위주.ICGA검사계발우AMD적CNV 54지안중,은닉성CNV(반상、초점상급혼합성CNV)11지안(20.37%),CNV반흔화17지안(31.48%).각병인조중이활동성CNV위주.계발우AMD적CNV중,활동성CNV 33지안(61.11%),정지성CNV 20지안(37.04%),미현영1지안(1.85%).결론 불동병인도치적CNV환자재년령、성별급각분류중차별교대,FFA화ICGA도상특정여병조활동성역불상동.전면세치분류대CNV병인학진단、종합치료급판단예후유중요의의.
Objecttve To investigate the clinical features of choroidal neovascularization (CNV) in different classifications.Methods In this retrospoctive case series,393 eyes of 312 patients with CNV between May 2005 and March 2007 in our department was classified based on their etiology,location,fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) findings.Results The relative frequency of various causes in CNV was as follows:there were 153 cases (49.04%) from age-related macular degeneration (AMD),94 cases (30.13%) from idiopathic CNV,37 cases (11.86%) from pathologic myopia,15 cases (4.81%) from inflammatory disorders,7 cases (2.24%) from polypoidal choroidal vasculopathy (PCV),3 cases (0.96%) from angioid streaks and 1 case (0.32%) from either hereditary disease or trauma or tumor,respectively.The majority cases from AMD was male (64.71%),whereas most from pathologic myopia,idiopathic CNV and inflammatory disorders were female (78.38%,73.40%,73.33%).The age range of the cases from AMD was 49-95 years (68.73±8.31),and 98.04% of them were at least 50 years old. Patients with idiopathic CNV aged 13-43 years old (29.86±6.45),and 84.04% of them were between 20 and 40 years old.The sex (χ2=57.17,P＜0.05) and age (F=172.57,P＜0.05) had significant difference in each etiological group.FFA showed that CNV in 43.48% from AMD and 66.67% from PCV were occult and non-classic.CNV in 91.67% from pathologic myopia,76.19% from inflammatory disorders and 95.00% from idiopathic CNV was classic.In each group,most of the CNV was subfoveal type (58.00%-100.00%),followed by iuxtafoveal type (0%-35.00%).In the ICGA of 54 eyes with AMD,11 eyes (20.37%) were occult CNV (plaque,spot and mixed CNV),17 eyes (31.48%) were CNV fibrosis.CNV was active in most cases.The frequency of active and inactive CNV in AMD was approximately 61.11% and 37.04%,respectively,no lesions were noted in 1 eye (1. 85%) in ICGA.Conclusions The clinical characteristics and frequency of various types of CNV are different due to different causes.Classification of CNV based on its etiology,FFA and ICGA findings,location,and activity in detail is important for the diagnosis,treatment and prognosis judgment in CNV.
