Lee Ji Eun, Shin Min Kyu, Chung In Young, Lee Joo Eun, Kim Hyun Woong, Lee Sang Joon, Park Sung Who, Byon Ik Soo
Department of Ophthalmology, College of Medicine, Pusan National University, Yangsan, Republic of Korea Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
Department of Ophthalmology, Gyeongsang National University, JinJu, Republic of Korea.
Br J Ophthalmol. 2016 May;100(5):652-9. doi: 10.1136/bjophthalmol-2015-306678. Epub 2015 Aug 31.
To investigate the relationship between idiopathic choroidal neovascularisation (CNV) and choroidal watershed zones (CWZs) using indocyanine green angiography (ICGA).
Multicentre, retrospective, interventional case series.
The medical records and ICGA findings of 44 patients (44 eyes) diagnosed with idiopathic CNV were reviewed. CWZs, defined as hypofluorescence that disappeared during the early phase of ICGA, were classified, and the findings were compared with those of a control group of 30 eyes. The topographical relationship between CWZs and CNV was evaluated. Visual acuity and recurrence were analysed according to the CWZ classification.
The CNV lesion was subfoveal in 16 eyes, juxtafoveal in 12 eyes and extrafoveal in 16 eyes. The most common types of CWZs were stellate (23 eyes, 52.3%) and vertical (19 eyes, 43.2%). CWZs involving the fovea were seen in more patients with idiopathic CNV (37 eyes, 84.1%) than in the control group (11 eyes, 36.7%, p<0.001). The topographical relationship between CWZs and CNV was determined in 42 eyes (95.5%), with the CNV located within the CWZ in 39 eyes and at the margin in 3 eyes. Extrafoveal CNV was within the CWZ in all 16 affected eyes. At 6 months, visual acuity was significantly worse in patients with subfoveal CNV (p=0.028) or stellate CWZs (p=0.039).
The findings of a CWZ were related to the location and functional outcome of idiopathic CNV. Our results suggest that choroidal circulation is a predisposing factor for the development of CNV in young patients.
使用吲哚菁绿血管造影（ICGA）研究特发性脉络膜新生血管（CNV）与脉络膜分水岭区（CWZ）之间的关系。
多中心、回顾性、介入性病例系列研究。
回顾了44例（44只眼）诊断为特发性CNV患者的病历和ICGA检查结果。将ICGA早期阶段消失的低荧光定义为CWZ并进行分类，并将结果与30只眼的对照组进行比较。评估CWZ与CNV之间的地形关系。根据CWZ分类分析视力和复发情况。
16只眼中CNV病变位于黄斑中心凹下，12只眼位于黄斑旁，16只眼位于黄斑外。CWZ最常见的类型是星状（23只眼，52.3%）和垂直状（19只眼，43.2%）。与对照组（11只眼，36.7%，p<0.001）相比，更多特发性CNV患者（37只眼，84.1%）出现累及黄斑中心凹的CWZ。42只眼（95.5%）确定了CWZ与CNV之间的地形关系，其中39只眼的CNV位于CWZ内，3只眼位于边缘。所有16只受累眼中黄斑外CNV均位于CWZ内。6个月时，黄斑中心凹下CNV患者（p=0.028）或星状CWZ患者（p=0.039）的视力明显更差。
CWZ的表现与特发性CNV的位置和功能结果相关。我们的结果表明脉络膜循环是年轻患者CNV发生的一个易感因素。
