Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Am J Ophthalmol. 2014 Mar;157(3):710-8.e1. doi: 10.1016/j.ajo.2013.12.011. Epub 2013 Dec 15.
To describe the clinical and imaging characteristics of choroidal neovascularization (CNV) accompanied by focal choroidal excavation.
Retrospective, interventional case series.
The medical records of 16 patients (16 eyes) were reviewed. Imaging findings including fluorescein angiography (FA), indocyanine green angiography, and spectral-domain optical coherence tomography (SD OCT) were analyzed.
CNV complexes were primarily located beneath the retinal pigment epithelium (type 1 CNV) in 9 eyes and in the subneurosensory retinal space (type 2 CNV) in 7 eyes, as assessed by SD OCT. Seven of 8 patients over 50 years old had type 1 CNV, and 6 of 8 patients under 50 had type 2 lesions. All 7 eyes with type 2 CNV exhibited classic CNV on FA. Additionally, 7 of 9 eyes with type 1 CNV had the classic pattern, and in these eyes, the CNV complexes were confined to the concavity of choroidal excavation. In 15 patients treated by anti-vascular endothelial growth factor (anti-VEGF) injections, the mean best-corrected visual acuity improved from 20/44 to 20/26 with a mean of 3.7 injections during a mean follow-up period of 14.5 months.
The CNV growth pattern and extent seem to be determined by the degree of damage to the retinal pigment epithelium/Bruch membrane complex resulting from choroidal excavation, as well as age. Neovascular complexes tend to be located within the boundary of choroidal excavation and are revealed as classic patterns on FA, even in type 1 CNV. Anti-VEGF was notably effective for treating these lesions, with a low rate of recurrence.
描述伴局限性脉络膜凹陷的脉络膜新生血管（CNV）的临床和影像学特征。
回顾性、干预性病例系列研究。
回顾性分析了 16 例（16 只眼）患者的病历。分析了包括荧光素血管造影（FA）、吲哚青绿血管造影和谱域光相干断层扫描（SD OCT）在内的影像学发现。
根据 SD OCT 评估，CNV 复合物主要位于视网膜色素上皮下方（1 型 CNV，9 只眼）和神经感觉视网膜下（2 型 CNV，7 只眼）。8 名年龄超过 50 岁的患者中有 7 名患有 1 型 CNV，8 名年龄小于 50 岁的患者中有 6 名患有 2 型病变。所有 7 只具有 2 型 CNV 的眼在 FA 上均显示出典型的 CNV。此外，9 只眼中有 7 只眼患有 1 型 CNV，具有典型模式，在这些眼中，CNV 复合物局限于脉络膜凹陷。在接受抗血管内皮生长因子（抗 VEGF）注射治疗的 15 例患者中，平均最佳矫正视力从 20/44 提高到 20/26，平均随访 14.5 个月，平均注射 3.7 次。
CNV 的生长模式和范围似乎取决于脉络膜凹陷引起的视网膜色素上皮/布鲁赫膜复合体损伤程度以及年龄。新生血管复合物倾向于位于脉络膜凹陷的边界内，即使在 1 型 CNV 中，也会在 FA 上显示出典型的模式。抗 VEGF 治疗这些病变的效果显著，复发率低。
