息肉样脉络膜血管病变诊疗进展

Current advance of polypoidal choroidal vasculopathy in diagnosis and treatment

息肉样脉络膜血管病变(PCV)是以脉络膜异常分支状血管网及末端息肉样血管扩张病灶为特点的血管性病变。PCV是一个独立的疾病还是湿性年龄相关性黄斑变性(AMD)的一个亚型,目前尚有争议。光相干断层扫描血流成像(OCTA)作为一种新的眼科影像检查技术,具备无创、快速、分辨率高的特点,其对血流的显影不受血管渗漏和视网膜出血的影响,能够提供三维测量的病变图像,并能实现病变的定量检测和分层检测和分析。OCTA用于多种眼科疾病的诊断和病情监测,有助于对PCV这类血管性疾病的认识。PCV的治疗经历了不同的阶段,目前已经进入抗血管内皮生长因子(VEGF)的时代,绝大多数PCV通过单纯抗VEGF治疗能够取得较好的疗效。本文就PCV的临床特征、诊断和治疗进展进行综述。

Polypoidal choroidal vasculopathy (PCV) is a kind of fundus disease characterized by choroidal anomalous branch vascular network and terminal polypoidal dilatation.The pathological basis of idiopathic choroidal neovascularization is similar to age-related macular degeneration (AMD).It is controversial that whether PCV and AMD is the same disease.Optical coherence tomography angiography (OCTA) is a new,noninvasive imaging technique that plays an important role in clinical practice.OCTA not only provides B-scans of the retina,but also offers rapid,high-resolution,repeated and accurate visualization of blood flow,which provides representation of the vascular morphology of the retina and choroid.OCTA is a noninvasive imaging modality capable of evaluating and assessing the morphology of PCV and their associated vascular patterns.The vascular endothelial growth factor (VEGF) participates in the pathophysiology of PCV,so anti-VEGF therapy has become the first-line treatment for PCV.Intravitreal injection of bevacizumab,ranibizumab,and aflibercept improves and stabilizes the vision of patients with PCV.In this article,we summarized the new progress of diagnosis and treatment associated with PCV.