脉络膜厚度及血液循环与特发性黄斑裂孔的相关关系研究现状

研究分析特发性黄斑裂孔的发生与发展对疾病的治疗和预防具有重要意义。最新研究提示,脉络膜厚度降低、血液循环减少可能是裂孔的致病因素。随着光学相干层析成像技术在临床上的应用,脉络膜厚度及血液循环在特发性黄斑裂孔发病及预后中的作用日益受到学者们的重视。本文就脉络膜厚度及血液循环变化与特发性黄斑裂孔发病关系的最新研究进行综述。

糖尿病患者脉络膜造影特征分析

目的:观察糖尿病患者的脉络膜循环特点,探讨糖尿病患者脉络膜循环的改变及其与DR发生发展的关系。方法:选取糖尿病患者45例分为NDR、NPDR、PDR三组,并选择20例健康正常人作为对照。采用德国海德堡共焦激光眼底扫描系统对所有糖尿病患者及正常对照同步进行FFA及ICGA,对比观察两种影像特点,阐述糖尿病患者脉络膜循环病变特点。结果:(1)DR各组患者视网膜中央动脉充盈时间与正常组相比无显著差异;脉络膜动脉充盈时间均较正常对照组减慢,有显著性差异(P<0.05)。(2)各组DR患者中,病变程度越重,发生充盈倒置的比例越大。(3)随着病变程度加重,造影早期脉络膜充盈不良及晚期斑点状强荧光的比例逐渐增多。结论:糖尿病患者进行ICGA揭示了脉络膜循环状态的异常,是FFA的一个重要补充,并且研究提示在DR发生之前已有脉络膜循环的异常,充分证明了糖尿病脉络膜病变的存在。

视网膜盘状瘢痕周围视网膜色素上皮萎缩的进展

Background/aims:Eyes with burnt out disciform scars secondary to age related macular degeneration(AMD)are regarded as visually stable.The aim of this study is to report the subsequent development of atrophy of the retinal pigment epithelium(RPE)around the scars and discuss the possible basis.Methods:20 eyes from 18 patients were observed to develop atrophy around choroidal neovascularisation(CNV).A method of measuring expansion of the atrophy over time is described using the Topcon Imagenet 2000 system.An additional 10 clinicopathological examples were reviewed.Results:Clinically CNV became surrounded initially by a ring of pallor that progressed to an expanding band of atrophy of the RPE.It developed most rapidly in the first 3 years after CNV became quiescent but then continued to expand slowly to more than three times the size of the scar.Histopathological specimens showed large choroidal vessels entering the scars directly and a reduced number of small choroidal vessels beneath and around the scar Conclusions:Disciform scars may become surrounded by an expanding band of atrophy of the RPE,postulated to result from remodelling of the choroidal circulation.The ongoing enlargement of the resulting scotoma may need to be considered when planning management and assessing treatment outcomes.

视网膜色素变性的吲哚青绿血管造影特征

目的 研究视网膜色素变性 (retinitis pigmentosa,RP)的脉络膜血液循环特征。 方法 对37例 RP患者行吲哚青绿血管造影 (indocyanine green angiography,ICGA) ,并与正常人眼对照。 结果 1RP组眼底荧光最早出现的平均时间 (14.38± 3.95 ) s,脉络膜静脉荧光开始充盈的平均时间 (17.2 7±5 .94) s,与对照组比较差异无显著性的意义 (P >0 .0 5 )。 2 RP组脉络膜血管荧光减弱的平均时间(4 75 .75± 15 3.70 ) s,较对照组明显缩短 (P<0 .0 0 0 1)。 3RP组眼底后部强荧光区的平均面积 (4 1.2 0±19.99) mm2 ,较对照组明显缩小 (P<0 .0 0 0 1)。 4ICGA中后期 RP组纱幕状荧光缺如 6 1只眼 ,占 84.7% ;斑状强荧光 2 1只眼占 2 9.2 % ,4只眼强荧光点渗漏 ,占 5 .6 %。 结论 1RP脉络膜血管灌注压无改变 ;2RP脉络膜血流量减少 ;3RP脉络膜毛细血管萎缩 ;