CAJ | 학술논문

目的观察息肉样脉络膜血管病变(PCV)静止性息肉样灶的吲哚青绿血管造影(ICGA)特征.方法回顾分析36例有静止性息肉样灶的PCV患者37只眼的临床资料.其中,11只眼随访了9～29个月,平均随访时间(12.3±5.5)个月.所有患眼均进行视力、眼压、裂隙灯显微镜、散瞳眼底检查,以及眼底彩色照相、荧光素眼底血管造影、ICGA检查.以ICGA检查早期发现囊袋样强荧光和晚期荧光渗漏或者着染者确定为活动性息肉样灶;ICGA检查发现囊袋样稍强荧光,晚期逐渐消退或者呈“冲刷”样表现者确定为静止性息肉样灶.以吲哚青绿开始注射至静止性息肉样灶开始显影的时间定为静止性息肉样灶的显影时间.根据临床和ICGA表现,将静止性息肉样灶分为无症状组、萎缩瘢痕组、结合组.对比观察各组的临床和影像特征以及随访观察眼底及病灶变化情况.结果 37只眼中,静止性息肉样灶的显影时间为8.2～27.0 min,平均显影时间(15.5±4.8) min.无症状组5只眼,占13.5％.眼底检查无出血、渗出、视网膜色素上皮脱离(PED)和(或)神经上皮脱离.ICGA检查有静止性息肉样灶显影.萎缩瘢痕组8只眼,占21.6％.眼底检查患眼黄斑区均有萎缩灶和(或)瘢痕灶,无出血、渗出、视网膜PED和(或)神经上皮脱离.ICGA检查显示其静止性息肉样灶位于萎缩灶或瘢痕灶边缘.结合组24只眼,占64.9％.眼底检查均无萎缩、瘢痕灶,其中10只眼有视网膜下出血,15只眼有视网膜渗出,10只眼有视网膜PED,4只眼有视网膜神经上皮脱离.ICGA检查显示静止性息肉样灶和活动性息肉样灶共存.随访的11只眼中,3只眼静止性息肉样灶完全消退,占27.3％;2只眼静止性息肉样灶部分消退,占18.2％;6只眼静止性息肉样灶无明显改变,占54.5％.结论 PCV的静止性息肉样灶主要在ICGA造影的中晚期显影,可出现于无症状眼、萎缩瘢痕眼以及与活动性息肉样灶共存眼等3种情况,其中与活动性息肉样灶共存是其主要形式. 目的觀察息肉樣脈絡膜血管病變(PCV)靜止性息肉樣竈的吲哚青綠血管造影(ICGA)特徵.方法迴顧分析36例有靜止性息肉樣竈的PCV患者37隻眼的臨床資料.其中,11隻眼隨訪瞭9～29箇月,平均隨訪時間(12.3±5.5)箇月.所有患眼均進行視力、眼壓、裂隙燈顯微鏡、散瞳眼底檢查,以及眼底綵色照相、熒光素眼底血管造影、ICGA檢查.以ICGA檢查早期髮現囊袋樣彊熒光和晚期熒光滲漏或者著染者確定為活動性息肉樣竈;ICGA檢查髮現囊袋樣稍彊熒光,晚期逐漸消退或者呈“遲刷”樣錶現者確定為靜止性息肉樣竈.以吲哚青綠開始註射至靜止性息肉樣竈開始顯影的時間定為靜止性息肉樣竈的顯影時間.根據臨床和ICGA錶現,將靜止性息肉樣竈分為無癥狀組、萎縮瘢痕組、結閤組.對比觀察各組的臨床和影像特徵以及隨訪觀察眼底及病竈變化情況.結果 37隻眼中,靜止性息肉樣竈的顯影時間為8.2～27.0 min,平均顯影時間(15.5±4.8) min.無癥狀組5隻眼,佔13.5％.眼底檢查無齣血、滲齣、視網膜色素上皮脫離(PED)和(或)神經上皮脫離.ICGA檢查有靜止性息肉樣竈顯影.萎縮瘢痕組8隻眼,佔21.6％.眼底檢查患眼黃斑區均有萎縮竈和(或)瘢痕竈,無齣血、滲齣、視網膜PED和(或)神經上皮脫離.ICGA檢查顯示其靜止性息肉樣竈位于萎縮竈或瘢痕竈邊緣.結閤組24隻眼,佔64.9％.眼底檢查均無萎縮、瘢痕竈,其中10隻眼有視網膜下齣血,15隻眼有視網膜滲齣,10隻眼有視網膜PED,4隻眼有視網膜神經上皮脫離.ICGA檢查顯示靜止性息肉樣竈和活動性息肉樣竈共存.隨訪的11隻眼中,3隻眼靜止性息肉樣竈完全消退,佔27.3％;2隻眼靜止性息肉樣竈部分消退,佔18.2％;6隻眼靜止性息肉樣竈無明顯改變,佔54.5％.結論 PCV的靜止性息肉樣竈主要在ICGA造影的中晚期顯影,可齣現于無癥狀眼、萎縮瘢痕眼以及與活動性息肉樣竈共存眼等3種情況,其中與活動性息肉樣竈共存是其主要形式.
목적 관찰식육양맥락막혈관병변(PCV)정지성식육양조적신타청록혈관조영(ICGA)특정.방법 회고분석36례유정지성식육양조적PCV환자37지안적림상자료.기중,11지안수방료9～29개월,평균수방시간(12.3±5.5)개월.소유환안균진행시력、안압、렬극등현미경、산동안저검사,이급안저채색조상、형광소안저혈관조영、ICGA검사.이ICGA검사조기발현낭대양강형광화만기형광삼루혹자착염자학정위활동성식육양조;ICGA검사발현낭대양초강형광,만기축점소퇴혹자정“충쇄”양표현자학정위정지성식육양조.이신타청록개시주사지정지성식육양조개시현영적시간정위정지성식육양조적현영시간.근거림상화ICGA표현,장정지성식육양조분위무증상조、위축반흔조、결합조.대비관찰각조적림상화영상특정이급수방관찰안저급병조변화정황.결과 37지안중,정지성식육양조적현영시간위8.2～27.0 min,평균현영시간(15.5±4.8) min.무증상조5지안,점13.5％.안저검사무출혈、삼출、시망막색소상피탈리(PED)화(혹)신경상피탈리.ICGA검사유정지성식육양조현영.위축반흔조8지안,점21.6％.안저검사환안황반구균유위축조화(혹)반흔조,무출혈、삼출、시망막PED화(혹)신경상피탈리.ICGA검사현시기정지성식육양조위우위축조혹반흔조변연.결합조24지안,점64.9％.안저검사균무위축、반흔조,기중10지안유시망막하출혈,15지안유시망막삼출,10지안유시망막PED,4지안유시망막신경상피탈리.ICGA검사현시정지성식육양조화활동성식육양조공존.수방적11지안중,3지안정지성식육양조완전소퇴,점27.3％;2지안정지성식육양조부분소퇴,점18.2％;6지안정지성식육양조무명현개변,점54.5％.결론 PCV적정지성식육양조주요재ICGA조영적중만기현영,가출현우무증상안、위축반흔안이급여활동성식육양조공존안등3충정황,기중여활동성식육양조공존시기주요형식.
Objective To observe the characteristics of indocyanine green angiography (ICGA) in inactive polypoidal lesions of polypoidal choroidal vasculopathy (PCV).Methods The clinical data of 36 PCV patients (37 eyes) with inactive polypoidal lesions were retrospectively analyzed.The follow-up of 11 eyes were ranged from nine to 29 months,with a mean of (12.3 ± 5.5) months.All the patients were examined for visual acuity,intraocular pressure,slit lamp microscope,fundus photography,fundus fluorescein angiography (FFA) and ICGA.According to the ICGA characteristics,PCV lesions were divided into active polypoidal lesions ( pocket like hyperfluorescence at early stage and fluorescence leakage or stained with fluorescein at late stage) and inactive polypoidal lesions (pocket like hyperfluorescence and it was gradually faded).According to clinical and ICGA characteristics,inactive polypoidal lesions were divided into asymptomatic group,atrophic and/or cicatricial group and combined (with active polypoidal lesions) group.The visual acuity,fundus,lesions change and image characteristics of three groups were evaluated and analyzed.Results Among the 37 eyes,the time from indocyanine green (ICG) injection to inactive polypoidal lesions begin showing was ranged from 8.2 to 27.0 minutes,with a mean of ( 15.5 ±4.8) minutes.There were five eyes (13.5％),eight eyes (21.6％) and 24 eyes (64.9％) in asymptomatic group,atrophic and/or cicatricial group and combined group,respectively.The results of fundus examination showed that there was no hemorrhage,exudates,retinal pigment epithelium detachment (PED) and/or neural retina detachment in asymptomatic group; atrophy lesions and/or scar lesions were observed in atrophic and/or cicatricial group and there was also no hemorrhage,exudate,PED and/or neural retinadetachment; there was no atrophy lesion and/or scar lesion,but there were 10 eyes with subretinal hemorrhage,15 eyes with retinal exudate,10 eyes with PED and four eyes with neural retina detachment in combine group.The results of ICGA showed that there were inactive polypoidal lesions in asymptomatic group; inactive polypoidal lesions located at the border of atrophy lesions and/or scar lesions in atrophic and/or cicatricial group; active polypoidal lesions and inactive polypoidal lesions coexisted in combine group.In 11 eyes which completed the follow-up,inactive polypoidal lesions regressed in three eyes (27.3％),partial regressed in two eyes (18.2％),unchanged in six eyes (54.5％).Conclusions The inactive polypoidal lesions of PCV mainly appear in the middle or late stage of ICGA and are manifested in asymptomatic,atrophic and/or cicatricial and combined eyes.The combined type which coexisted with active polypoidal lesions is the main form.