息肉状脉络膜血管病变的临床表现及眼底血管造影

Clinical findings and characteristics of FFA and ICGA in polypoidal choroidal vasculopathy

目的 观察息肉状脉络膜血管病变 (polypiodal choroidal vasculopathy,PCV)的临床表现及眼底血管造影特征。 方法 回顾分析 6例 PCV患者 7只眼的临床资料及荧光素眼底血管造影 (fundusfluorescein angiography,FFA)与吲哚青绿血管造影 (indocyanine green angiography,ICGA)检查资料。 结果 PCV患者早期眼底仅可见橘红色病变 ,随病情进展出现出血、渗出、水肿、浆液性和 (或 )出血性视网膜色素上皮 (retinal pigment epithelium,RPE)脱离 ,病程长者可出现视网膜、脉络膜萎缩。 FFA检查 1只眼病变处脉络膜血管网扩张 ,6只眼见密度不均的斑点状强荧光 ,造影过程中荧光渗漏 ,晚期呈强度不均的强荧光片 ;ICGA检查 5只眼早期显示分支状脉络膜血管网 ,末端扩张呈息肉状 ,晚期脉络膜血管结构不清 ,息肉状扩张仍然可辨 ,7只眼均有形态独特的孤立或簇状分布的息肉状强荧光点 ,晚期仍有染料存留。 结论 PCV患者眼底可见橘红色病变及出血、渗出和 RPE脱离 ,FFA及 ICG检查可见分支状脉络膜血管网及末端息肉状扩张。

Objective To investigate the clinical features of polypoidal choroidal vasculopathy. Methods The clinical manifestations and the findings of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) of 7 eyes in 6 patients with polypoidal choroidal vasculopathy were analyzed retrospectively. Results The ophthalmoscopic examination of PCV in this series of patients revealed orange-red lesions mainly in macular region in early stage, and then hemorrhage, exudation, edema, serous and (or) hemorrhagic detachment of retinal pigment epithelium in affected portions in advanced stage, and retinal and choroidal atrophy in late stage. FFA discovered the vascular dilation at the border of the choroidal vascular network in 1 eye, dotted hyperfluorescence in 6 eyes, and patches of hyperfluorescence in late phase. ICGA disclosed a vascular branching network in choroid with polypoid pattern of the terminal path of the vessels of network in early phase in 5 eyes, and the typical dotted or clustered polypoidal hyperfluorescence in 7 eyes in late phase. Conclusion The characteristic findings of FFA and ICGA are very diagnostic for PCV.