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息肉样脉络膜血管病变的临床特征与脉络膜血管通透性的关系。

Relationship between clinical characteristics of polypoidal choroidal vasculopathy and choroidal vascular hyperpermeability.

机构信息

Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.

出版信息

Am J Ophthalmol. 2013 Feb;155(2):305-313.e1. doi: 10.1016/j.ajo.2012.07.018. Epub 2012 Sep 27.

Abstract

PURPOSE

To investigate the relationship between the clinical characteristics of polypoidal choroidal vasculopathy (PCV) and choroidal vascular hyperpermeability seen on indocyanine green angiography.

DESIGN

Retrospective, consecutive, interventional case series.

METHODS

We reviewed the medical records and the angiograms of 89 patients with PCV. The relationship between choroidal vascular hyperpermeability and background factors, associated clinical manifestations, and treatment responses to intravitreal injections of ranibizumab were evaluated.

RESULTS

Of the 89 patients with PCV, 31 patients (34.8%) demonstrated choroidal vascular hyperpermeability. The patients with choroidal vascular hyperpermeability more frequently showed bilateral neovascular membrane than those without choroidal vascular hyperpermeability (P=.009) and had a significant relationship with a history of central serous chorioretinopathy (CSC) (P=.01). Of the 98 eyes with treatment-naïve PCV, 34 eyes with choroidal vascular hyperpermeability demonstrated significantly greater subfoveal thickness than the 64 eyes without choroidal vascular hyperpermeability (P < .001). However, no significant relationship was found between choroidal vascular hyperpermeability and the other biomicroscopic and angiographic phenotypes of PCV. Three monthly intravitreal injections of ranibizumab were performed on 57 patients with treatment-naïve PCV, and the presence of choroidal vascular hyperpermeability was significantly related to the persistent retinal fluid 1 month after the third ranibizumab injection (P=.01).

CONCLUSIONS

The patients with PCV associated with choroidal vascular hyperpermeability more frequently demonstrated bilateral neovascular membrane, a history of CSC, a thickened choroid, and poor responses to intravitreal injections of ranibizumab than those without choroidal vascular hyperpermeability.

摘要

目的

探讨息肉样脉络膜血管病变(PCV)的临床特征与吲哚菁绿血管造影(ICGA)所见脉络膜血管高通透性之间的关系。

设计

回顾性、连续、干预性病例系列。

方法

我们回顾了 89 例 PCV 患者的病历和血管造影。评估了脉络膜血管高通透性与背景因素、相关临床表现以及玻璃体腔注射雷珠单抗治疗反应之间的关系。

结果

在 89 例 PCV 患者中,有 31 例(34.8%)表现出脉络膜血管高通透性。与无脉络膜血管高通透性的患者相比,有脉络膜血管高通透性的患者更常出现双侧新生血管膜(P=.009),且与中心性浆液性脉络膜视网膜病变(CSC)病史有显著关系(P=.01)。在 98 只未经治疗的 PCV 眼中,有 34 只眼有脉络膜血管高通透性,其黄斑中心凹下厚度明显大于 64 只无脉络膜血管高通透性的眼(P <.001)。然而,脉络膜血管高通透性与 PCV 的其他显微镜和血管造影表型之间没有显著关系。对 57 例未经治疗的 PCV 患者进行了每月一次的玻璃体腔注射雷珠单抗治疗,脉络膜血管高通透性的存在与第三次雷珠单抗注射后 1 个月视网膜液持续存在显著相关(P=.01)。

结论

与无脉络膜血管高通透性的患者相比,伴有脉络膜血管高通透性的 PCV 患者更常出现双侧新生血管膜、CSC 病史、脉络膜增厚和对玻璃体腔注射雷珠单抗治疗反应不佳。

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