老年性黄斑变性脉络膜新生血管的组织病理学特征

Characteristics of histopathology of choroidal neovascular membrane in age-related macular degeneration

目的 观察老年性黄斑变性 (AMD)脉络膜新生血管 (CNV)吲哚青绿血管造影 (ICGA)表现与其组织病理学变化的关系。 方法 ICGA检查确诊的 AMD患者 2 1例 2 1只眼 ,根据 ICGA检查结果将 CNV分成活动期、消退期、静止期 ,通过玻璃体切割手术取出 CNV,光学显微镜、透射电子显微镜观察不同期 CNV的组织病理学特征。 结果 活动期 CNV9只眼 ,组织病理学特征为大量 CNV,无色素性细胞和纤维组织或有少量色素性细胞将其部分包裹 ;消退期 CNV9只眼 ,组织病理学特征为 CNV较活动期减少 ,有较多色素性细胞、少量的纤维组织 ;静止期 CNV3只眼 ,组织病理学特征为大量的纤维组织 ,无CNV或有极少 CNV,无色素性细胞。 结论 渗出型 AMD患者 CNV的组织病理学特征与 ICGA表现具有一定的相关性。

Objective To investigate the manifestations of indocyanine green angiography (ICGA) of the choroidal neovascular membrane (CNV) and the relationship with histopathological changes in patients with age-related macular degeneration (AMD). Methods Twenty-one eyes of 21 patients with AMD diagnosed by ICGA were classified into three types based on ICGA findings: developing type in 9 eyes, degenerating type in 9, and stabilizing type in 3. CNV was extracted by vitrectomy and the histopathological characteristics of CNV was observed under the light and electron microscope. Results The histopathological characteristics of the specimens of developing type revealed abundant CNV partly enwrapped with non-pigmental cells and fibrous tissue or a few pigmental cells; degenerating type revealed reduced activation duration of CNV, many pigmental cells and a little fibrous tissue; stabilizing type revealed a mass of fibrous tissue,few CNV and nonexistence of pigmental cells. Conclusion The histopathological characteristics of exudative AMD may be related to the manifestations of ICGA.