Vitreous, Macula, Retina Consultants, New York, New York.
Institute of Ophthalmology, Fundación Conde de Valenciana, Mexico City, Mexico.
Retina. 2021 May 1;41(5):997-1004. doi: 10.1097/IAE.0000000000003004.
To evaluate the choroidal vascular patterns of patients with pachychoroid-related diseases in eyes images with wide-field indocyanine green angiography.
Retrospective study of wide-field indocyanine green angiographic images of patients with pachychoroid, peripapillary pachychoroid syndrome, central serous chorioretinopathy, and pachychoroid-associated neovascularization that were evaluated for anastomoses between vortex vein systems, which are ordinarily separated by a watershed zone.
There were 21 subjects with a mean age of 57.4 years and 15 were male. Among the 42 eyes evaluated, central serous chorioretinopathy was found in 24 eyes (57.1%), peripapillary pachychoroid syndrome in 5 (11.9%), pachychoroid associated neovascularization in 7 (16.7%), and pachychoroid in 6 (14.3%). Every eye showed anastomosis between the superonasal, superotemporal, and inferotemporal vortex vein systems. The inferonasal vortex vein system was less likely to demonstrate anastomosis except for peripapillary pachychoroid syndrome, which showed anastomosis in all eyes. The anastomotic connections were prominent in the central macula in the central serous chorioretinopathy and pachychoroid-associated neovascularization cases, and around the nerve in the peripapillary pachychoroid syndrome cases. Although the large choroidal veins were particularly prominent in the neovascular cases, the number was fewer in the macular region than in other pachychoroid-related diseases in this series. Compared with a control group of nine eyes, the inferotemporal-superotemporal-superonasal anastomotic connections were more common in the case group (P < 0.001) and inferonasal quadrant (P = 0.023 right eye; P = 0.01, left eye).
Intervortex venous anastomosis is common in pachychoroid, central serous chorioretinopathy, peripapillary pachychoroid syndrome, and pachychoroid-associated neovascularization. This finding has important implications concerning pathogenesis and classification of disease.
通过广角吲哚菁绿血管造影评估与厚脉络膜相关疾病患者的脉络膜血管模式。
回顾性研究广角吲哚菁绿血管造影图像，评估厚脉络膜、视盘周围厚脉络膜综合征、中心性浆液性脉络膜视网膜病变和厚脉络膜相关新生血管化患者涡静脉系统之间的吻合，这些患者通常在分水岭区被分隔。
21 名受试者的平均年龄为 57.4 岁，15 名男性。在评估的 42 只眼中，24 只眼（57.1%）为中心性浆液性脉络膜视网膜病变，5 只眼（11.9%）为视盘周围厚脉络膜综合征，7 只眼（16.7%）为厚脉络膜相关新生血管化，6 只眼（14.3%）为厚脉络膜。每只眼均显示鼻上、颞上和颞下涡静脉系统之间的吻合。除视盘周围厚脉络膜综合征外，下鼻侧涡静脉系统不太可能显示吻合，所有眼均显示吻合。在中心性浆液性脉络膜视网膜病变和厚脉络膜相关新生血管化病例中，吻合连接在中央黄斑明显，在视盘周围厚脉络膜综合征病例中，吻合连接在神经周围明显。尽管在新生血管病例中大脉络膜静脉特别明显，但在该系列中与其他厚脉络膜相关疾病相比，黄斑区的数量较少。与 9 只眼的对照组相比，病例组中颞下-颞上-鼻上吻合连接更常见（P < 0.001），并且在下鼻象限（右眼 P = 0.023；左眼 P = 0.01）。
涡静脉间吻合在厚脉络膜、中心性浆液性脉络膜视网膜病变、视盘周围厚脉络膜综合征和厚脉络膜相关新生血管化中很常见。这一发现对疾病的发病机制和分类具有重要意义。
