息肉样脉络膜血管病变的光相干断层扫描

Optical Coherence Tomography of Polypoidal Choroidal Vasculopathy

目的 :观察息肉样脉络膜血管病变 (polypoidalchoroidalvasculopathy ,PCV )的光相干断层扫描 (opticalcoherencetomography ,OCT)图像特征。方法 :对比分析常规眼底检查、荧光素眼底血管造影 (fundusfluoresceinangiography ,FFA )及吲哚青绿血管造影 (indocyaninegreenangiography ,ICGA)检查确诊的PCV患者 9例 9眼 (PCV组 )、渗出型老年性黄斑变性 (exudativeage -relatedmaclarde generation ,AMD)引起的浆液性视网膜色素上皮脱离 (retinalpigmentepithelialdetachments ,RPED) 11例 11眼、中心性渗出性脉络膜视网膜病变 (centralexudativechoroidoretinopathy ,CEC)引起RPED 2例 2眼 (浆液性RPED组 )的OCT检查图像资料 ,观察PCV患眼视网膜下结节样病灶特征、RPED隆起高度和基底宽度的相关性。结果 :PCV眼OCT图像表现为RPE和脉络膜毛细血管高反射层呈穹隆状隆起 ,表面不规则 ,边缘陡峭。其下或视网膜色素上皮 (retinalpigmentepithelial ,RPE)光带水平可见结节样改变。 3眼有RPED ,5眼RPED合并神经上皮脱离。RPE隆起高度和基底宽度比率 :PCV组 (0 14 5 1± 0 0 40 0 )较浆液性RPED组 (0 0 876± 0 0 3 2 5 )高 (t =-3 3 2 4,P =0 0 0 4) ,高度和基底宽度呈线形关系 。

Objective:To investigate the cross-sectional images of optical coherence tomography (OCT) in eyes with polypoidal choroidal vasculopathy (PCV). Methods:9 cases (9 eyes) diagnosed PCV by fundus photography,fundus fluorescein angiography(FFA) and indocyanine green angiography(ICGA) were examined by OCT.11 cases (11 eyes) of serous retinal pigment epithelium detachment in exudative age-related maclar degeneration(AMD) and 2 cases (2 eyes) in central exudative choroidoretinopathy(CEC) were examined by OCT.The images of OCT and correlation between the height and the base diameter of reddish-orange lesions were analyzed. Results:OCT showed cone-like elevation of the RPE and the inner choroid,and highly reflective band or nodular appearance were seen beneath or at the lever of RPE (6 eyes).The retinal pigment epithelium detachment (RPED) and RPED associated with sensory retinal detachment were seen respectively in 3 eyes and 5 eyes.The distribution pattern of the points showed the former have a more sharply peaked shape than the latter. Conclusions:The characteristics of OCT for PCV manifested prominent anterior protrusion of the inner choroid,uneven surface and steep edge of polypoidal lesions.The wall of the reddish-orange nodule disclosed a highly reflective band that consisted of RPE and anterior wall of polypoidal lesion.The polypoidal vascular lesion could be situated beneath the Bruch membrane.