息肉样脉络膜血管病变的临床观察

[Clinical observation of polypoidal choroidal vasculopathy].

作者信息

Zou Wen-Jun, Wen Feng, Wu Zhi-Feng, Huang Shi-Zhou, Zhang Jie, Luo Guang-Wei

机构信息

Department of Ophthalmology, Second Affiliated Hospital, Nanjing Medical University, Wuxi 214002, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2011 Jan;47(1):39-44.

PMID:21418926

Abstract

OBJECTIVE

To observe the natural course and evaluate the prognostic factors influencing the follow-up visual acuity of polypoidal choroidal vasculopathy (PCV).

METHODS

It was a retrospective case series. Forty-five consecutive patients (51 eyes) who were diagnosed with PCV by fundus photography, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were followed up with (11.1 ± 2.0) months (mean ± SD). Age, baseline visual acuity, the presence of pigment epithelium detachment (PED), lesion size, the polypoidal lesions involving the fovea and the regression of polypoidal lesions were recorded. Multi-factor regression analysis of visual acuity at follow up was applied with SPSS 16.0 statistics software.

RESULTS

Among the 45 patients (51 eyes), the hemorrhage or exudation were increased in 15 eyes (29.4%), decreased in 25 eyes (49.0%), 5 eyes (9.8%) developed macula scar and 6 eyes (11.8%) macula atrophy. During the follow-up period, the visual acuity was improved in 11 eyes (21.6%), stable in 21 (41.2%) and regressed in 19 (37.2%). Twenty-five eyes (49.0%) demonstrated polypoidal lesions involving the fovea and 26 eyes (51.0%) did not. ICGA revealed that the polypoidal lesions were unchanged in 18 eyes (35.3%), regressed in 13 (25.5%), grew in 13 (25.5%), and mixed in 7 eyes (13.7%). The changes of visual acuity at follow up were related to the age, baseline visual acuity, and polypoidal lesions involving in the fovea (b = -0.005, 0.382 and -0.430; P = 0.034, 0.000 and 0.000). Improvement of visual acuity at follow up was related to the regression of polypoidal lesions (b = 2.259, P = 0.019, OR = 9.578).

CONCLUSIONS

There is a large variation in the visual prognosis in Chinese patients with PCV. The presence of PED and the lesion size had no effect on the visual prognosis of PCV. Better visual acuity during follow-up period is correlated with younger age, better baseline visual acuity, polypoidal lesions not involving the fovea and a regression of polypoidal lesions.

摘要

目的

观察息肉样脉络膜血管病变（PCV）的自然病程，并评估影响其随访视力的预后因素。

方法

这是一项回顾性病例系列研究。连续纳入45例（51只眼）经眼底照相、眼底荧光血管造影（FFA）及吲哚菁绿血管造影（ICGA）确诊为PCV的患者，随访时间为（11.1±2.0）个月（均值±标准差）。记录患者年龄、基线视力、色素上皮脱离（PED）情况、病变大小、累及黄斑中心凹的息肉样病变以及息肉样病变的消退情况。采用SPSS 16.0统计软件对随访视力进行多因素回归分析。

结果

45例（51只眼）患者中，15只眼（29.4%）出血或渗出增多，25只眼（49.0%）减少，5只眼（9.8%）出现黄斑瘢痕，6只眼（11.8%）出现黄斑萎缩。随访期间，11只眼（21.6%）视力提高，21只眼（41.2%）稳定，19只眼（37.2%）视力下降。25只眼（49.0%）息肉样病变累及黄斑中心凹，26只眼（51.0%）未累及。ICGA显示，18只眼（35.3%）息肉样病变无变化，13只眼（25.5%）消退，13只眼（25.5%）增大，7只眼（13.7%）混合变化。随访视力变化与年龄、基线视力及累及黄斑中心凹的息肉样病变有关（b = -0.005、0.382及-0.430；P = 0.034、0.000及0.000）。随访视力提高与息肉样病变消退有关（b = 2.259，P = 0.019，OR = 9.578）。