發(fā)布時間：2018-07-15 22:45

【摘要】：目的 觀察息肉樣脈絡(luò)膜血管病變（polypoidal choroidal vasculopathy，PCV）的臨床特征。 方法 回顧分析我院自2008年7月～2012年4月確診為PCV的174例（206眼）患者的眼底彩色照相（fundus photography，F(xiàn)P）、熒光素眼底血管造影（fundusfluorescein angiography，F(xiàn)FA）、吲哚青綠脈絡(luò)膜血管造影(indocyanine greenangiography, ICGA)和相干光斷層成像（optical coherence tomography，OCT）。 結(jié)果 1.眼底檢查發(fā)現(xiàn)：橘紅色病灶146眼（70.9%）；視網(wǎng)膜出血79眼（38.3%）；硬性滲出71眼(34.5%)；玻璃膜疣8眼（3.9%）。 2.FFA檢查發(fā)現(xiàn)：144眼（70.0%）早期見密度不均的斑點狀強熒光，晚期呈強度不均的強熒光斑片；49眼（23.8%）表現(xiàn)為大片遮蔽熒光；色素上皮脫離為99眼(48.1%)。 3.ICGA檢查發(fā)現(xiàn)：息肉樣高熒光位于黃斑區(qū)149眼（72.3%），視盤區(qū)20眼（9.7%），，血管弓區(qū)19眼（9.2%）;18眼位于混合區(qū)(8.7%),其中黃斑區(qū)+視盤區(qū)4眼(1.9%),黃斑區(qū)+血管弓區(qū)10眼(4.9%),視盤區(qū)+血管弓區(qū)4眼(1.9%)。息肉樣病灶呈孤立樣17眼（8.3%），呈簇樣189眼（91.7%）；脈絡(luò)膜異常分支血管網(wǎng)149眼（72.3%）；晚期地圖樣高熒光110眼（53.4%）。 4.OCT檢查發(fā)現(xiàn)：PCV的異常分支血管網(wǎng)表現(xiàn)為視網(wǎng)膜色素上皮層呈扁平波紋狀隆起，RPE層與Bruch’s膜之間可見中至高的反射信號68眼（41.5%）；PCV的異常分支血管網(wǎng)表現(xiàn)為RPE層較高隆起，其下可見中高反射和(或)出血（漿液）信號64眼(39.0%)。 結(jié)論 PCV以視網(wǎng)膜下橘紅色病灶為其眼底特征;FFA造影早期見密度不均的斑點狀強熒光，晚期呈強度不均的斑駁狀強熒光斑片，漿液性或出血性色素上皮脫離多見;ICGA造影表現(xiàn)為息肉樣高熒光，脈絡(luò)膜異常分支血管和晚期地圖樣高熒光，息肉樣病灶多位于黃斑部;PCV的異常分支血管網(wǎng)OCT表現(xiàn)為視網(wǎng)膜色素上皮層和Bruch’s膜之間的中高反射信號。
[Abstract]:Objective to observe the clinical features of polypoid choroidal angiopathy (polypoidal choroidal). Methods from July 2008 to April 2012, 174 patients (206eyes) with PCV diagnosed in our hospital were analyzed retrospectively, including fundus photography (FP), fundusfluorescein angiography (FFA), indocyanine green choroidal angiography (indocyanine greenangiography, ICGA), and Coherence tomography (Oct). Result 1. Fundus examination revealed orange lesions in 146 eyes (70.9%), retinal hemorrhage in 79 eyes (38.3%), rigid exudation in 71 eyes (34.5%), vitreous verruca in 8 eyes (3.9%). 49 eyes (23.8%) with intensity uneven in the late stage showed large obscured fluorescence. 3.The polypoid hyperfluorescence was found in 149 eyes (72.3%) in macular area, 20 eyes (9.7%) in optic disc area, and 19 eyes (9.2%) in vascular arch area in mixed area (8.7%). 4 eyes (1.9%) were located in macular area, 4 eyes (1.9%) in macular area and 19 eyes (9.2%) in vascular arch area. Vascular arch in 10 eyes (4.9%) and optic disc in 4 eyes (1.9%). 17 eyes (8.3%) were solitary, 189 eyes (91.7%) were cluster like, 149 eyes (72.3%) were abnormal choroidal branch vascular network. (4) the abnormal branch vascular network of 1: PCV was found in 68 eyes (41.5%) with moderate and high reflectance between the RPE layer of retinal pigment epithelium and the Bruchus membrane, and the abnormal branch vascular network was found in 68 eyes (41.5%). The abnormal branch vascular network of PCV showed a higher bulge of RPE layer, which showed moderate hyperreflex and / or hemorrhage signal in 64 eyes (39.0%). Conclusion the fundus feature of PCV is subretinal orange-red focus. FFA imaging shows that the density is uneven in the early stage, and the intensity is uneven in the late stage. In serous or hemorrhagic pigment epithelium detachment, ICGA showed polypoid hyperfluorescence, choroidal abnormal branching vessels and late map hyperfluorescence. Most of the polypoid lesions were located in the abnormal branch of macular PCV. Oct showed the middle and high reflex signal between the retinal pigment epithelium and the Bruchus membrane.
【學位授予單位】：濟南大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R773.4

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1 孫祖華;文峰;陳艷麗;吳德正;黃時洲;羅光偉;關(guān)天芹;劉彩嬌;;50歲以上患者視網(wǎng)膜色素上皮脫離的眼底特征分析[J];中華眼底病雜志;2006年04期

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