山东大学耳鼻喉眼学报 ›› 2017, Vol. 31 ›› Issue (4): 98-102.doi: 10.6040/j.issn.1673-3770.0.2016.228

• 论著 • 上一篇    下一篇

息肉状脉络膜血管病变的临床表现分析

颜昕,王翠,赵博军   

  1. 山东大学附属省立医院眼科中心, 山东 济南 250021
  • 收稿日期:2016-05-19 出版日期:2017-08-16 发布日期:2017-08-16
  • 通讯作者: 赵博军. E-mail:zhaobojun@hotmail.com
  • 基金资助:
    山东省自然科学基金(ZR2015HM026)

Clinical manifestations of polypoidal choroidal vasculopathy.

YAN Xin, WANG Cui, ZHAO Bojun   

  1. Deparment of Ophthalmology, Shandong Provincial Hospital affiliated to Shandong University, Jinan 250021, Shandong, China
  • Received:2016-05-19 Online:2017-08-16 Published:2017-08-16

摘要: 目的 探讨息肉状脉络膜血管病变(PCV)患者的流行病学特点及临床表现特征。 方法 回顾性分析2011年8月至2015年1月收治的PCV患者87例(107眼),分析其流行病学特点、眼底检查、荧光素钠眼底血管造影(FFA)及吲哚菁绿眼底血管造影(ICGA)检查资料。 结果 87例(107眼)PCV患者中,男性占57.5%(50例),单眼受累占77.0%(67例)。41~92岁,平均(66.4±9.4)岁。51.4%(55眼)见出血性视网膜色素上皮层脱离(PED),45.8%(49眼)见视网膜下橘红色隆起改变。77.6%(83眼)息肉状病灶位于黄斑区,息肉状病灶1~8个,平均(2.71±1.79)个,单灶性与多灶性息肉状病灶中最大者平均面积分别为(0.52±0.35)mm2和(0.49±0.37)mm2结论 PCV患者多见于男性,以单眼发病为主,临床表现为好发于黄斑区的出血性PED及视网膜下橘红色隆起改变,单灶性息状病的平均面积大于息肉状病灶中最大者的平均面积。

关键词: 息肉状脉络膜血管病变, 吲哚菁绿眼底血管造影, 临床特征, 荧光素钠眼底血管造影

Abstract: Objective To investigate the demographic features and clinical manifestations of polypoidal choroidal vasculopathy(PCV). Methods We retrospectively reviewed 107 eyes in 87 consecutive outpatients with a diagnosis of PCV in the Department of Ophthalmology, Shandong Provincial Hospital from August 11, 2011 to January 28, 2015. All the patients underwent an epidemiological inquiry, routine eye examination, color fundus photography fluorescein angiography and indocyanine green angiography(ICGA). Results Among the 87 PCV patients, there was a male predominance with 50(57.5%)male patients. 67(77.0%)patients were affected unilaterally. The average age was 66.4±9.4 years old(range, 41-92). Based on fundus examination, the commonest clinical fundus feature was hemorrhagic pigment epithelial detachment(PED)(55 eyes, 51.4%), which was followed by sub-retinal orange-red bulging lesions(49 eyes, 45.8%). ICGA showed that polyps located in the macular area in 83(77.6%)eyes. The average number of polypoidal lesions was 2.71±1.79(ranged from 1 to 8). The mean area of the solitary polyp and the largest one of multiple polyps was 0.52±0.35 mm2, 0.49±0.37 mm2 respectively. Conclusion Among our patients with PCV, male, unilateral, macular location of polypoidal lesions with hemorrhagic PED and sub-retinal orange-red bulging lesion are the commonest clinical fundus manifestations. In ICGA, the mean area of PCV with solitary polyp was larger than the biggest one of PCV with multiple polyps.

Key words: Polypoidal choroidal vasculopathy, Fluorescein fundus angiography, Indocyanine green angiography, Clinical manifestation

中图分类号: 

  • R774
[1] Imamura Y, Engelbert M, Iida T, et al. Polypoidal choroidal vasculopathy: a review[J]. Surv Ophthalmol, 2010, 55(6):501-515.
[2] Laude A, Cackett PD, Vithana EN, et al. Polypoidal choroidal vasculopathy and neovascular age-related macular degeneration: same or different disease?[J]. Prog Retin Eye Res, 2010, 29(1):19-29.
[3] Byeon SH, Lee SC, Oh HS, et al. Incidence and clinical patterns of polypoidal choroidal vasculopathy in Korean patients[J]. Jpn J Ophthalmol, 2008, 52(1):57-62.
[4] Honda S, Matsumiya W, Negi A. Polypoidal choroidal vasculopathy: clinical features and genetic predisposition[J]. Ophthalmologica, 2014, 231(2):59-74.
[5] Wong RL, Lai TY. Polypoidal choroidal vasculopathy: an update on therapeutic approaches[J]. J Ophthalmic Vis Res, 2013, 8(4):359-371.
[6] Maruko I, Iida T, Saito M, et al. Clinical characteristics of exudative age-related macular degeneration in Japanese patients[J]. Am J Ophthalmol, 2007, 144(1):15-22.
[7] Liu Y, Wen F, Huang S, et al. Subtype lesions of neovascular age-related macular degeneration in Chinese patients[J]. Graefes Arch Clin Exp Ophthalmol, 2007, 245(10):1441-1445.
[8] Cackett P, Wong D, Yeo I. A classification system for polypoidal choroidal vasculopathy[J]. Retina, 2009, 29(2):187-191.
[9] Tsujikawa A, Nakanishi H, Ojima Y, et al. Macular polypoidal choroidal vasculopathy with a remote lesion[J]. Clin Exp Ophthalmol, 2008, 36(9):817-823.
[10] Kwok AK, Lai TY, Chan CW, et al. Polypoidal choroidal vasculopathy in Chinese patients[J]. Br J Ophthalmol, 2002, 86(8):892-897.
[11] Yamaoka S, Okada AA, Sugahara M, et al. Clinical features of polypoidal choroidal vasculopathy and visual outcomes in the absence of classic choroidal neovascularization[J]. Ophthalmologica, 2010, 224(3):147-152.
[12] Japanese Study Group of Polypoidal Choroidal Vasculopathy. Criteria for diagnosis of polypoidal choroidal vasculopathy[M]. Japanese: Nippon Ganka Gakkai Zasshi, 2005:417-427.
[13] Tan CS, Ngo WK, Chen JP, et al. EVEREST study report 2: imaging and grading protocol, and baseline characteristics of a randomised controlled trial of polypoidal choroidal vasculopathy[J]. Br J Ophthalmol, 2015, 99(5):624-628.
[14] Hou J, Tao Y, Li XX, et al. Clinical characteristics of polypoidal choroidal vasculopathy in Chinese patients[J]. Graefes Arch Clin Exp Ophthalmol, 2011, 249(7):975-979.
[15] Wen F, Chen C, Wu D, et al. Polypoidal choroidal vasculopathy in elderly Chinese patients[J]. Graefes Arch Clin Exp Ophthalmol, 2004, 242(8):625-629.
[16] Lafaut BA, Leys AM, Snyers B, et al. Polypoidal choroidal vasculopathy in Caucasians[J]. Graefes Arch Clin Exp Ophthalmol, 2000, 238(9):752-759.
[17] Yannuzzi LA, Wong DW, Sforzolini BS, et al. Polypoidal choroidal vasculopathy and neovascularized age-related macular degeneration[J]. Arch Ophthalmol, 1999, 117(11):1503-1510.
[18] Ciardella AP, Donsoff IM, Huang SJ, et al. Polypoidal choroidal vasculopathy[J]. Surv Ophthalmol, 2004, 49(1):25-37.
[19] Sho K, Takahashi K, Yamada H, et al. Polypoidal choroidal vasculopathy: incidence, demographic features, and clinical characteristics[J]. Arch Ophthalmol, 2003, 121(10):1392-1396.
[20] Hayashi H, Yamashiro K, Gotoh N, et al. CFH and ARMS2 variations in age-related macular degeneration, polypoidal choroidal vasculopathy, and retinal angiomatous proliferation[J]. Invest Ophthalmol Vis Sci, 2010, 51(11):5914-5919.
[21] 刘会娟, 陈中山, 丁琴, 等. 362例息肉样脉络膜血管病变患者的临床特征分析[J]. 中华眼底病杂志, 2013, 29(4):376-379. LIU Huijuan, CHEN Zhongshan, DING Qin, et al. Clinical characteristics of 362 cases of polypoidal choroidal vasculopathy[J]. Chin J Ocul Fund Dis, 2013, 29(4):376-379.
[22] 刘冉, 李加青, 曾婧, 等. 渗出型老年性黄斑变性与息肉样脉络膜血管病变患者年龄、性别及发病眼别的比较[J]. 中华眼底病杂志, 2012, 28(5):445-448. LIU Ran, LI Jiaqing, ZENG Jing, et al. Compare neovascular age-related macular degeneration and polypoidal choroidal vasculopathy in age at diagnosis, gender and disease laterality[J]. Chin J Ocul Fund Dis, 2012, 28(5):445-448.
[23] Scassellati-Sforzolini B, Mariotti C, Bryan R, et al. Polypoidal choroidal vasculopathy in Italy[J]. Retina, 2001, 21(2):121-125.
[24] Mori K, Horie-Inoue K, Gehlbach PL, et al. Phenotype and genotype characteristics of age-related macular degeneration in a Japanese population[J]. Ophthalmology, 2010, 117(5):928-938.
[25] Cackett P, Htoon H, Wong D, et al. Haemorrhagic pigment epithelial detachment as a predictive feature of polypoidal choroidal vasculopathy in a Chinese population[J]. Eye(Lond), 2010, 24(5):789-792.
[26] 史雪辉, 魏文斌, 田蓓, 等. 脉络膜新生血管的病变特征分析[J]. 中华眼科杂志, 2008, 44(9):780-785. SHI Xuehui, WEI Wenbin, TIAN Bei, et al. Analysis of clinical features of choroidal neovascularization[J]. Chin J Ophthalmol, 2008, 44(9):780-785.
[27] Yeung L, Chen SN. Polypoidal choroidal vasculopathy in Taiwan[J]. Chang Gung Med J, 2004, 27(5):366-372.
[28] Cheung CM, Laude A, Wong W, et al. Improved specificity of polypoidal choroidal vasculopathy diagnosis using a modified everest criteria[J]. Retina, 2015, 35(7):1375-1380.
[29] Suzuki M, Nagai N, Shinoda H, et al. Distinct responsiveness to intravitreal ranibizumab therapy in polypoidal choroidal vasculopathy with single or multiple polyps[J]. Am J Ophthalmol, 2016, 166:52-59.
[1] 许明,罗兴谷,唐洪波,江青山. 儿童突发性聋的临床特征及预后相关因素分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 41-44.
[2] 刘学升,李筱瑜,邓玮. 后半规管良性阵发性位置性眩晕急性发作时的临床表现[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 11-13.
[3] 刘英,季青,封新荣,刘文. 中老年人真菌球性鼻窦炎临床特征及鼻内镜手术观察[J]. 山东大学耳鼻喉眼学报, 2016, 30(4): 98-100.
[4] 杜然, 王佳琳, 王艳玲. 视网膜色素变性差异性临床表现及影像学特征[J]. 山东大学耳鼻喉眼学报, 2015, 29(5): 87-90.
[5] 周荣金, 王俊国. 鼻咽部肌上皮癌1例报告并文献复习[J]. 山东大学耳鼻喉眼学报, 2014, 28(4): 33-34.
[6] 薛飞,江满杰,程友,王锦玲,周玫,王秋萍,李泽卿. 周围神经遗传病合并听神经病4例并文献复习[J]. 山东大学耳鼻喉眼学报, 2009, 23(3): 25-27.
[7] 梅 芳,陈志钧,徐再兴 . 小儿视网膜母细胞瘤17例[J]. 山东大学耳鼻喉眼学报, 2008, 22(1): 25-26 .
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!