病理性近视脉络膜新生血管的诊断与治疗

Diagnosis and treatment of choroidal neovascularization in pathologic myopia

病理性近视是全世界范围内引起患者视力下降的主要原因之一,在亚洲国家尤为多见。而脉络膜新生血管是病理性近视的最严重并发症之一,它可以引起眼底黄斑区病变,导致视力下降,出现中心暗点,视物变形,视野缺损等,如长期不治疗可能导致失明。光学相干断层扫描、光学相干断层扫描血管成像、荧光素眼底血管造影等检查方法在诊断病理性近视继发的脉络膜新生血管中起到很大帮助,可以较为明确的显示新生血管的位置,大小等,不论其是否处于活动期。目前对于病理性近视引起的脉络膜新生血管主要治疗方法有光动力治疗及抗血管内皮生长因子(VEGF)治疗,近年来,玻璃体腔内注射抗VEGF药物成为病理性近视与脉络膜新生血管的首选治疗方法,通过减少新生血管的形成,减轻黄斑区水肿,从而达到改善视力及更好的预后效果。论文主要综合整理近期关于病理性近视脉络膜新生血管的诊断及治疗的研究,为临床工作提供帮助。

Pathologic myopia(PM)is a major cause of vision loss worldwide,particularly in Asian countries.Choroidal neovascularization(CNV)is a severe complication of PM,which can cause macular disorders,leading to central scotoma,metamorphopsia,visual field loss,and finally blindness if not treated.The advents of optical coherence topography(OCT),OCT angiography,and fundus fluorescein angiography are helpful in diagnosing CNV due to PM,which can show the position and size of CNV,whether active or passive.For the treatment,photodynamic and anti-vascular endothelial growth factor(anti-VEGF)therapies are widely applied.In recent years,administering the intravitreal anti-VEGF injection has become the first-line treatment for CNV secondary to PM.Many clinical studies have indicated that intravitreal anti-VEGF injections affect antagonizing neovascularization and reduce macular edema,thereby contributing to visual improvements and better long-term outcomes.This article provides an overview of the current diagnosis and treatment options for myopic CNV.