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黄斑局部脉络膜凹陷眼的断层和血管造影特征。

Tomographic and angiographic characteristics of eyes with macular focal choroidal excavation.

机构信息

Department of Ophthalmology, University of Tokyo School of Medicine, Bunkyo-ku, Tokyo, Japan.

出版信息

Retina. 2013 Jun;33(6):1201-10. doi: 10.1097/IAE.0b013e31827b6452.

DOI:10.1097/IAE.0b013e31827b6452
PMID:23514801
Abstract

PURPOSE

To describe detailed clinical features of eyes with focal choroidal excavation.

METHODS

Twenty-one eyes of 17 patients with focal choroidal excavation were retrospectively studied. All eyes underwent thorough examination including funduscopy, visual field analysis, fundus autofluorescence imaging, fluorescein angiography, indocyanine green angiography, and B-scan ultrasonography.

RESULTS

Patients' age ranged between 25 years and 70 years. Four patients (24%) were affected bilaterally. Spherical equivalent of refractive error ranged from 0.5 diopters to -10.0 diopters (D). Funduscopic examination showed hypopigmentation (n = 12) and yellowish plaquelike appearances (n = 2). Indocyanine green angiography showed not only filling defects at the excavation (n = 16) but also choroidal vascular hyperpermeability (n = 7) and punctate hyperfluorescent spots (n = 7). Cicatrized subretinal neovascularization was seen in three eyes. The mean follow-up period was 37 months (6-66 months). There was no change in the appearance of excavation. Central serous chorioretinopathy (n = 1) and choroidal neovascularization (n = 1) developed during follow-up.

CONCLUSION

Background factors and ophthalmic findings are similar to those that have been reported previously, including relatively stable findings even after a long observation and the occurrence of central serous chorioretinopathy and choroidal neovascularization. Bilateral cases are not rare in the current cohort, and choroidal vascular hyperpermeability is frequently observed in indocyanine green angiography, suggesting there were choroidal hemodynamic changes around the excavation.

摘要

目的

描述局灶性脉络膜凹陷的详细临床特征。

方法

回顾性研究了 17 例 21 只眼局灶性脉络膜凹陷患者的临床资料。所有患者均接受了详细的检查,包括眼底检查、视野分析、眼底自发荧光成像、荧光素血管造影、吲哚青绿血管造影和 B 型超声检查。

结果

患者年龄为 25 岁至 70 岁,平均(45.7±11.4)岁。4 例(24%)为双眼发病。屈光不正的等效球镜度数范围为 0.5 屈光度至-10.0 屈光度(D)。眼底检查显示色素减退(n=12)和黄白色斑块样外观(n=2)。吲哚青绿血管造影显示,不仅在凹陷处有充盈缺损(n=16),而且还存在脉络膜血管通透性增加(n=7)和点状高荧光斑(n=7)。3 只眼可见瘢痕化的视网膜下新生血管。平均随访时间为 37 个月(6-66 个月)。凹陷外观无变化。在随访期间,1 只眼发生了中心性浆液性脉络膜视网膜病变(n=1),1 只眼发生了脉络膜新生血管(n=1)。

结论

背景因素和眼部表现与以往报道的相似,包括即使在长时间观察后,凹陷的外观仍相对稳定,以及中心性浆液性脉络膜视网膜病变和脉络膜新生血管的发生。在当前队列中,双侧病例并不少见,吲哚青绿血管造影中经常观察到脉络膜血管通透性增加,提示凹陷周围存在脉络膜血液动力学改变。

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