黄斑中心凹旁渗出性血管异常复合体的临床特征及治疗研究进展

Progress in clinical features and treatment of perifoveal exudative vascular anomalous complex

黄斑中心凹旁渗出性血管异常复合体(PEVAC)是一类非常罕见的黄斑血管疾病,以一孤立的位于中心凹旁的大动脉瘤样病变为主要特征,可同时伴有视网膜内小出血和渗出。患者的临床症状主要表现为不同程度的视力下降。临床上常与黄斑毛细血管扩张症1型、3型黄斑新生血管等相混淆。深入了解PEVAC的临床特征,对其鉴别诊断尤为重要。由于PEVAC的发病机制尚不明确,故缺乏针对病因的特异性治疗措施。多数学者采用玻璃体腔注射抗血管内皮生长因子药物治疗,但并不能提高患者视力;目前多尝试采用单纯或联合激光光凝治疗以消除病灶的异常渗出,维持视功能,达到良好的预后。当前仍需探究PEVAC的发病机制,提升对该病的认识,以求寻找更好的治疗方案。

Perifoveal exudative vascular anomalous complex(PEVAC)is a very rare macular vascular disease characterized by an isolated large aneurysmal lesion in the fovea,with accompanied by small retinal hemorrhage and exudation.The main clinical symptoms of the patients are various degree of impaired vision.Clinically,it is often confused with type 1 macular telangiectasia and type 3 macular neovascularization.A thorough understanding of the clinical features of PEVAC is particularly important for its differential diagnosis.Due to the unclear pathogenesis of PEVAC,there is no specific treatment for the cause of disease.Most scholars use intravitreal injection against vascular endothelial growth factor drugs for treatment,but can not improve patients'visual acuity.At present,many attempts have been made to eliminate abnormal exudation of the lesion,maintain visual function and achieve a good prognosis by simple or combined laser photocoagulation.At present,it is still necessary to explore the pathogenesis of PEVAC,improve the understanding of the disease,and find a better treatment plan.