旁中心凹渗出性血管异常复合体

Perifoveal exudative vascular anomalous complex

旁中心凹渗出性血管异常复合体(PEVAC)是指相干光断层扫描(OCT)成像显示在旁中心凹视网膜表层或深层毛细血管网出现的大而孤立的动脉瘤样病灶,被确定为一种独立的新疾病。患者多为中老年人,不伴有视网膜血管病变,但可合并近视或年龄相关性黄斑变性等。若合并视网膜血管性疾病如糖尿病视网膜病变、视网膜静脉阻塞时,被称为PEVAC样病变。疾病早期无渗出,后期可有视网膜内渗出引起视物变形或视力下降。一些病例长期随访病灶无变化或自发消散。可能需要与3型视网膜新生血管(RAP)和Ⅰ型MacTel鉴别。抗血管内皮生长因子(VEGF)疗法无效。有用微脉冲激光等治疗改善的个案。推测此病与视网膜微血管周细胞变性有关。

·Parafoveal exudative vascular anomalous complex(PEVAC)refers to a large,isolated aneurysmal lesion in the superficial or deep capillary plexus of the parafoveal retina demonstrated by optical coherence tomography(OCT)imaging and has been identified as a new entity.Patients are almost middle-aged and elder people,not accompanied by retinal vascular diseases,but can develop with myopic or age-related macular degeneration(ARMD).It has been defined as PEVAC-resembling lesions when associated with retinal vascular diseases,such as diabetic retinopathy(DR)or retinal vein occlusion.It is non-exudative in the early stage,but later intraretinal exudation may induce metamorphopsia or visual decline.In some cases,the lesion was unchanged or spontaneously resolved during long-term follow-up.Differentiation from type 3 retinal neovascularization(retinal angiomatous proliferation,RAP)and Type I MacTel may be required.The anti-vascular endothelial growth factor(VEGF)therapy is ineffective and micropulse laser treatment could achieve improvement in a few cases.It is speculated that the lesion is associated with degeneration of retinal microvascular pericytes.