息肉状脉络膜血管病变眼底影像检查特征

Fundus imaging characteristics of polypoidal choroidal vasculopathy

目的探讨息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)眼底影像特征。方法回顾性分析PCV患者32例(32眼)的眼底检查资料,所有患者均经荧光素眼底血管造影、吲哚青绿血管造影和光学相干断层扫描(optical coherence tomography,OCT)检查确诊。结果 32眼中6眼表现为异常分支状脉络膜血管网,异常血管网造影后期荧光逐渐减弱;21眼表现为不同程度的息肉状脉络膜血管扩张灶,在造影早期呈囊袋样或结节样强荧光,造影后期表现为渗漏、染色、冲刷现象或者消退;5眼表现为PCV与脉络膜新生血管共同存在。表现为异常分支状脉络膜血管网的6眼OCT检查发现视网膜色素上皮及视网膜色素上皮下的两层强反射,即双层征;而表现为息肉状脉络膜血管扩张灶的26眼OCT检查发现脉络膜内层的突兀状结节样隆起,隆起的下面有中等反射存在。结论 PCV在吲哚青绿血管造影和OCT检查中有其特征性眼底影像表现,掌握这些特点有助于与湿性年龄相关性黄斑变性相鉴别,对患者预后的判断和治疗方法的选择都具有重要的临床意义。

Objeetive To investigate the fundus imaging characteristics of polypoidal choroidal vasculopathy（PCV）. Methods A retrospective analysis of 32 cases （32 eyes） with PCV confirmed by fundns fluorescein angiography, indocyanine green angiog- raphy and optical coherence tomography （OCT） was performed. Results In 32 eyes,6 eyes showed abnormal branching choroidal vascular network, the abnormal vascular net- work imaging fluorescence gradually weakened in the late ;21 eyes showed expansive le- sions of PCV for different degrees, showed pouch-like or nodular strong fluorescence in the early, and leakage, staining, erosion phenomena or dissipated in the late; 5 eyes showed co-exist of PCV and choroidal neovascularization. 6 eyes with abnormal branching vascular network had two layers of strong reflection under the retinal pigment epithelium and sub-retinal pigment epithelium by OCT, which was the two-tier levy. And 25 eyes with expansive lesions of polypoidal choroidal vasculopathy revealed the awkward-shapednodular bulge,and there was moderate reflex under the bulge. Conelusion Characteristic fundus imaging findings can be detected by indocyanine green angiography and OCT in PCV, mastering these features will contribute to distinguish it with age- related degeneration, which has important clinical significance on prognosis judgment and treatment options.