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伴有脉络膜血管高通透性的息肉样脉络膜血管病变

Polypoidal choroidal vasculopathy with choroidal vascular hyperpermeability.

作者信息

Sasahara Manabu, Tsujikawa Akitaka, Musashi Kunihiro, Gotoh Norimoto, Otani Atsushi, Mandai Michiko, Yoshimura Nagahisa

机构信息

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.

出版信息

Am J Ophthalmol. 2006 Oct;142(4):601-7. doi: 10.1016/j.ajo.2006.05.051.

Abstract

PURPOSE

To describe the incidence and clinical characteristics of polypoidal choroidal vasculopathy (PCV) associated with choroidal vascular hyperpermeability.

DESIGN

Retrospective observational case series.

METHODS

We reviewed the medical records of 122 consecutive eyes with PCV and 106 consecutive eyes with exudative age-related macular degeneration (AMD). Fluorescein angiography and indocyanine green (ICG) angiography were performed using a confocal scanning laser system. In the midphase of ICG angiography, we evaluated choroidal vascular hyperpermeability, which is recognized as one of the characteristic findings in central serous chorioretinopathy (CSC). Choroidal vascular hyperpermeability appeared as multifocal patchy areas of hyperfluorescence with blurred margins within the choroid that increased in intensity with time after injection of the dye.

RESULTS

Of 122 eyes with PCV, 12 (9.8%) eyes of 10 patients exhibited multifocal choroidal hyperfluorescence in the midphase of ICG angiography, whereas two (1.9%) of 106 eyes with exudative AMD showed a similar appearance (P = .013). Of the 12 eyes in 10 patients with PCV that demonstrated multifocal choroidal hyperfluorescence, we also noted that the early phase of ICG angiography showed choroidal filling delay in seven eyes (58%) and venous dilation in 12 eyes (100%). Four of these 12 eyes (33%) had a medical history of CSC, and nine (90%) of the 10 patients revealed multifocal choroidal hyperfluorescence bilaterally.

CONCLUSIONS

Multifocal choroidal hyperfluorescence seen by ICG angiography occurs more frequently in eyes with PCV than in those with AMD. Choroidal vascular hyperpermeability, reportedly a characteristic finding in CSC, might be one of the risk factors of PCV.

摘要

目的

描述与脉络膜血管高通透性相关的息肉样脉络膜血管病变(PCV)的发病率及临床特征。

设计

回顾性观察病例系列。

方法

我们回顾了122例连续的PCV患者的眼部病历以及106例连续的渗出性年龄相关性黄斑变性(AMD)患者的眼部病历。使用共焦扫描激光系统进行荧光素血管造影和吲哚菁绿(ICG)血管造影。在ICG血管造影的中期,我们评估脉络膜血管高通透性,这被认为是中心性浆液性脉络膜视网膜病变(CSC)的特征性表现之一。脉络膜血管高通透性表现为脉络膜内多个边界模糊的高荧光斑片状区域,在注射染料后随时间强度增加。

结果

在122例PCV患者的眼中,10例患者的12只眼(9.8%)在ICG血管造影中期表现出多灶性脉络膜高荧光,而106例渗出性AMD患者的眼中有2只眼(1.9%)表现出类似外观(P = 0.013)。在10例表现出多灶性脉络膜高荧光的PCV患者的12只眼中,我们还注意到ICG血管造影早期7只眼(58%)出现脉络膜充盈延迟,12只眼(100%)出现静脉扩张。这12只眼中有4只眼(33%)有CSC病史,10例患者中有9例(9)0%)双眼表现出多灶性脉络膜高荧光。

结论

ICG血管造影所见的多灶性脉络膜高荧光在PCV患者眼中比在AMD患者眼中更常见。据报道,脉络膜血管高通透性是CSC的特征性表现,可能是PCV的危险因素之一。

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