Department of Ophthalmology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1247, Japan.
Graefes Arch Clin Exp Ophthalmol. 2010 Mar;248(3):361-8. doi: 10.1007/s00417-009-1276-2.
When we classified neovascular exudative age-related macular degeneration (AMD) into three types of polypoidal choroidal vasculopathy (PCV), typical AMD, and retinal angiomatous proliferation (RAP) in our previous study, we reported 5.5% had the combined cases, such as one eye had PCV and the other eye had typical AMD. We examined the clinical characteristics of these combined cases in the current study.
All cases underwent fluorescein and indocyanine green angiography (FA and ICGA) at the initial examination. All PCV cases were diagnosed definitively based on characteristic aneurysmal lesions seen on ICGA. Follow-up examinations also were conducted to determine whether polypoidal lesions had developed in the eyes with typical AMD.
Among 349 patients with neovascular AMD, 20 (5.7%) had one eye with PCV and the other eye with typical AMD. The average age was 73 years. The mean best-corrected visual acuity levels at the initial examination in eyes with PCV and typical AMD were 0.20 and 0.43, respectively (p=0.09). All subgroups of classic and occult CNV were observed in the eyes with typical AMD on FA. During the follow-up period (average, 21.7 months), PCV developed in ten eyes with typical AMD at the initial examination.
Although some cases might include different stages of progression or probable cases of PCV, the combined cases in which one eye has PCV and the other eye has typical AMD suggest that those clinical entities are not independent and possibly overlap.
在我们之前的研究中，我们将新生血管性渗出性年龄相关性黄斑变性（AMD）分为 3 种类型：息肉样脉络膜血管病变（PCV）、典型 AMD 和视网膜血管瘤样增生（RAP）。我们报告说，有 5.5%的病例为合并病例，例如一只眼为 PCV，另一只眼为典型 AMD。在本研究中，我们检查了这些合并病例的临床特征。
所有病例在初次检查时均进行了荧光素和吲哚青绿血管造影（FA 和 ICGA）。所有 PCV 病例均根据 ICGA 上可见的特征性动脉瘤样病变明确诊断。还进行了随访检查，以确定典型 AMD 眼中是否出现了息肉样病变。
在 349 例新生血管性 AMD 患者中，有 20 例（5.7%）一只眼为 PCV，另一只眼为典型 AMD。平均年龄为 73 岁。在 PCV 眼和典型 AMD 眼的初次检查中，最佳矫正视力水平的平均值分别为 0.20 和 0.43（p=0.09）。在 FA 中，典型 AMD 眼中观察到所有亚组的经典和隐匿性 CNV。在初次检查时，典型 AMD 眼中有 10 只眼在随访期间（平均 21.7 个月）发展为 PCV。
尽管有些病例可能包括不同阶段的进展或可能的 PCV 病例，但一只眼为 PCV，另一只眼为典型 AMD 的合并病例表明这些临床实体并非独立存在，可能存在重叠。
