息肉状脉络膜血管病变临床诊治初步报告

Preliminary Report of the Diagnosis and Treatment for Polypoidal Choroidal Vasculopathy

目的观察息肉状脉络膜血管病变(PCV)临床特点、病程变化和预后。方法4例PCV患者经行眼底彩照、眼底荧光血管造影和吲哚氰绿血管造影确诊,随访时间6～26个月,观察患者临床特点、最佳矫正视力、眼底彩照、荧光素眼底血管造影或吲哚氰绿眼底血管造影检查结果、患者接受的治疗方式及其预后。结果4例患者4只眼,眼底均表现为视网膜下出血以及血液性或浆液血液性视网膜色素上皮脱离,均能透见特征性的视网膜下橘红色病灶。吲哚氰绿造影(ICGA)均显示息肉状病灶。1只眼接受了PDT治疗,另外3只眼接受药物保守治疗。1只眼息肉状病灶完全消失,1只眼息肉状病灶部分消退。随访视力0.3以上3只眼。1只眼出现玻璃体出血。结论PCV患者诊断明确,病程预后相对好,光动力疗法是有效治疗方法,但应结合患者自身情况选取治疗方法。

Objective To observe the characteristics of the ocular fundus, the changes of disease course and prognosis of visual acuity of patients with polypoidal choroidal vasculopathy （PCV）. Methods 4 patients with PCV were diagnosed by fundus photography, fundus fluorescein angiography （FFA） or indocyanine green angiography （ICGA）. The fellow-up time range from 6 to 26 monthes, the best corrected visual acuity（ BCVA）, fundus photochromes, FFA and ICGA, treatment of these 4 eyes were observed. Results 4 patients （4 eyes） with PCV all have subretinal hemorrhage, hemorrhagic or serous retinal pigment epithelium detachment（PED） and tuberculum-like focus in tangerine at the posterior pole. In ICGA all have polypoidal dilations. One eye was treated by PDT, the other three eyes treated by medicine. The result of ICGA revealed the polypoidal lesions that were spontaneously regressed completely in 1 eye, partly regressed in one eye . The visual acuity was improved in 3 eyes and better than 0.3. One eye suffered vitreous homorrhage. Conclusion The diagnosis of PCV is clear. PCV showed a better prognosis. Photodynamic therapy with visudyne could be a choice for the treatment of PCV. We should choose different types of treatments according to each patient.