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息肉样脉络膜血管病变

Polypoidal Choroidal Vasculopathy.

作者信息

Goldhardt Raquel, Rosen Bradley Simon

机构信息

Miami Veterans Administration Medical Center, Miami, FL, USA.

Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, Miami, FL.

出版信息

Curr Ophthalmol Rep. 2019 Mar;7(1):66-72. doi: 10.1007/s40135-019-00201-4. Epub 2019 Feb 2.

Abstract

PURPOSE OF REVIEW

The aim of this review is to summarize developments in the treatment of active polypoidal choroidal vasculopathy (PCV). PCV is associated with a poor visual prognosis as a consequence the condition's hallmark polypoidal dilatation and a branching network resulting in recurrent hemorrhages and serous leakage.

RECENT FINDINGS

Recent research has provided new insights into the pathogenesis of PCV. While still considered a subtype of age-related macular degeneration, suggestions that PCV belongs to a spectrum of conditions that present with a pachychoroid are increasingly well accepted. Treatment remains challenging. Combination therapy (photodynamic therapy (PDT) and intravitreal anti-vascular endothelial growth factor (VEGF)) is associated with higher polyp closure rate, but polyp closure rate has not been correlated with superior visual outcomes. Current data points to non-inferiority of anti-VEGF alone versus combined with PDT when final vision acuity is the study outcome.

SUMMARY

PCV remains a clinical challenge. Classification and treatment of the condition continues to evolve. Combination therapy may not be superior to anti-VEGF treatment alone in terms of visual acuity outcome, however data on long-term recurrence should be compared in formulating preferred treatment plans.

摘要

综述目的

本综述旨在总结活动性息肉样脉络膜血管病变(PCV)治疗方面的进展。PCV因具有标志性的息肉样扩张和分支状血管网,易导致反复出血和浆液性渗漏,从而预后视力较差。

最新研究成果

近期研究为PCV的发病机制提供了新见解。尽管PCV仍被视为年龄相关性黄斑变性的一种亚型,但越来越多的人接受了PCV属于厚脉络膜相关疾病谱的观点。治疗仍然具有挑战性。联合治疗(光动力疗法(PDT)和玻璃体内注射抗血管内皮生长因子(VEGF))息肉闭合率较高,但息肉闭合率与更好的视力预后并无关联。当以最终视力为研究结果时,目前的数据表明单独使用抗VEGF与联合PDT相比并无劣势。

总结

PCV仍然是一项临床挑战。该疾病的分类和治疗仍在不断发展。就视力结果而言,联合治疗可能并不优于单独使用抗VEGF治疗,然而在制定首选治疗方案时,应比较长期复发的数据。

相似文献

1
Polypoidal Choroidal Vasculopathy.息肉样脉络膜血管病变
Curr Ophthalmol Rep. 2019 Mar;7(1):66-72. doi: 10.1007/s40135-019-00201-4. Epub 2019 Feb 2.
2
[Polypoidal choroidal vasculopathy].[息肉样脉络膜血管病变]
Nippon Ganka Gakkai Zasshi. 2012 Mar;116(3):200-31; discussion 232. doi: 10.4264/numa.71.282.
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Photodynamic therapy for polypoidal choroidal vasculopathy.光动力疗法治疗息肉样脉络膜血管病变。
Prog Retin Eye Res. 2013 Nov;37:182-99. doi: 10.1016/j.preteyeres.2013.09.003. Epub 2013 Oct 15.

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