CAJ | 학술논문

目的分析黄斑区息肉状脉络膜血管病变(PCV)在吲哚菁绿眼底血管造影(ICGA)中的不同渗漏亚型及临床特点.方法对经荧光素眼底血管造影(FFA)及ICGA确诊为PCV的137例144只患眼进行ICGA渗漏状态的分型及各型临床特点的分析.结果在144只PCV患眼的ICGA中,110只眼出现晚期染料渗漏(渗漏型,76%).渗漏型又可分为三个亚型:息肉灶渗漏型(47只眼,42.7%)、异常分支状脉络膜血管渗漏型(14只眼,12.7%)和混合渗漏型(49只眼,44.5%).其他34只眼显示出晚期病灶的消退和(或)呈冲刷现象(消退型,24%).在渗漏型中,色素上皮脱离(PED)、最佳矫正视力(BCVA)<0.1及陈旧性视网膜下出血的比例分别为56.4%(62只眼),19.1%(21只眼)和4.6%(5只眼);消退型相应比例分别为8.8%(3只眼)、50%(17只眼)和38.2%(13只眼)(P<0.001),同时消退型的病程显著长于渗漏型(P<0.001).结论在ICGA中可以观察PCV病灶的晚期渗漏及消退现象,其中以渗漏型居多.混合性渗漏是渗漏型中最常见的亚型.渗漏型多表现PED,较好的BCVA以及较短的病程,而消退型则更易表现视网膜下陈旧性出血、较差的BCVA以及较长的病程.这可能提示前者为活动性病灶或处于疾病的早期阶段,而后者则为静止性病灶或处于疾病的晚期阶段.
목적 분석황반구식육상맥락막혈관병변(PCV)재신타정록안저혈관조영(ICGA)중적불동삼루아형급림상특점.방법 대경형광소안저혈관조영(FFA)급ICGA학진위PCV적137례144지환안진행ICGA삼루상태적분형급각형림상특점적분석.결과 재144지PCV환안적ICGA중,110지안출현만기염료삼루(삼루형,76%).삼루형우가분위삼개아형:식육조삼루형(47지안,42.7%)、이상분지상맥락막혈관삼루형(14지안,12.7%)화혼합삼루형(49지안,44.5%).기타34지안현시출만기병조적소퇴화(혹)정충쇄현상(소퇴형,24%).재삼루형중,색소상피탈리(PED)、최가교정시력(BCVA)<0.1급진구성시망막하출혈적비례분별위56.4%(62지안),19.1%(21지안)화4.6%(5지안);소퇴형상응비례분별위8.8%(3지안)、50%(17지안)화38.2%(13지안)(P<0.001),동시소퇴형적병정현저장우삼루형(P<0.001).결론 재ICGA중가이관찰PCV병조적만기삼루급소퇴현상,기중이삼루형거다.혼합성삼루시삼루형중최상견적아형.삼루형다표현PED,교호적BCVA이급교단적병정,이소퇴형칙경역표현시망막하진구성출혈、교차적BCVA이급교장적병정.저가능제시전자위활동성병조혹처우질병적조기계단,이후자칙위정지성병조혹처우질병적만기계단.
Objective To investigate the angiographic classification of polypoidal lesions in polypoidal choroidal vasculopathy (PCV) on indocyanine green angiography (ICGA). Methods One hundred and forty four eyes of 137 patients diagnosed as PCV were prospectively observed. Fundus examination, color fundus photography and ICGA were performed. Angiographic classification of polypoidal lesions and clinical features were recorded. Results In all 144 eyes, 110 eyes showed angiographic leakage (leakage group, 76%) on ICGA and three subtypes of the leakage group were noted, which were polypoidal dilations leakage (47 eyes, 42.7%), branching vascular networks leakage (14 eyes, 12.7%) and leakage of both (49 eyes, 44.5%). The other 34 eyes showed regression of polypoidal lesions (regression group, 24%). In leakage group, the rates of pigment epithelial detachment (PED), best corrected visual acuity (BCVA) <0.1 and old subretinal hemorrhages were respectively 56.4% (62 eyes), 19.1% (21 eyes), and 4.6% (5 eyes), compared with 8.8% (3 eyes), 50% (17 eyes) and 38.2% (13 eyes) for regression group (P<0.001). The history of regression group was significantly longer (P<0.001). Conclusions Angiographic leakage and regression can be observed in PCV lesions. Leakage of both polypoidal dilations and branching vascular networks is the most common subtype in leakage group. PCV in leakage group is more likely to be related to PED, better BCVA and shorter history, while PCV in regression group tends to relevant to old subretinal hemorrhage, worse BCVA and longer history. This may reflect the former is active or in the early course while the latter is resting or in the late phase of PCV.