Borooah Shyamanga, Sim Peng Yong, Phatak Sumita, Moraes Gabriella, Wu Chris Yang, Cheung Chui Ming Gemmy, Pal Bishwanath, Bujarborua Dhiren
Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA.
Moorfields Eye Hospital NHS Foundation Trust, London, UK.
Acta Ophthalmol. 2021 Sep;99(6):e806-e822. doi: 10.1111/aos.14683. Epub 2020 Nov 30.
Recent improvements in ophthalmic imaging have led to the identification of a thickened choroid or pachychoroid to be associated with a number of retinal diseases. The number of conditions linked to this phenotype has continued to widen with specific endophenotypes found within the pachychoroid spectrum. The spectrum includes choroidal features such as focal or diffuse choroidal thickening and thinning of the overlying inner choroid, and choroidal hyperpermeability as demonstrated by indocyanine green angiography. In addition, these diseases are associated with overlying retinal pigmentary changes and retinal pigment epithelial dysfunction and may also be associated with choroidal neovascularization. This article provides a comprehensive review of the literature looking at diseases currently described within the pachychoroid spectrum including central serous chorioretinopathy, pachychoroid pigment epitheliopathy, pachychoroid neovasculopathy, polypoidal choroidal vasculopathy/aneurysmal type 1 neovascularization, peripapillary pachychoroid disease and focal choroidal excavation. We particularly focus on clinical imaging, genetics and pathological findings in these conditions with the aim of updating evidence suggesting a common aetiology between diseases within the pachychoroid spectrum.
眼科成像技术的最新进展已使人们认识到脉络膜增厚或厚脉络膜与多种视网膜疾病相关。与这种表型相关的疾病数量持续增加，在厚脉络膜谱系中发现了特定的内表型。该谱系包括脉络膜特征，如局限性或弥漫性脉络膜增厚以及上方内层脉络膜变薄，以及吲哚青绿血管造影显示的脉络膜高渗透性。此外，这些疾病与上方视网膜色素改变和视网膜色素上皮功能障碍相关，也可能与脉络膜新生血管形成有关。本文全面综述了目前在厚脉络膜谱系中描述的疾病的文献，包括中心性浆液性脉络膜视网膜病变、厚脉络膜色素上皮病变、厚脉络膜新生血管病变、息肉样脉络膜血管病变/1型动脉瘤样新生血管形成、视盘周围厚脉络膜疾病和局限性脉络膜凹陷。我们特别关注这些疾病的临床成像、遗传学和病理发现，目的是更新证据，表明厚脉络膜谱系内疾病之间存在共同病因。
