Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Eonjuro 211, Gangnam-gu, Seoul, Republic of Korea.
Translational Genome Informatics Laboratory, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, Republic of Korea.
Graefes Arch Clin Exp Ophthalmol. 2021 Aug;259(8):2391-2400. doi: 10.1007/s00417-021-05180-6. Epub 2021 Apr 27.
To investigate the relationship between pachydrusen and features of choroidal vascular hyperpermeability (CVH) and punctate hyperfluorescent spots (PHS) on serial imaging in patients with polypoidal choroidal vasculopathy (PCV) or pachychoroid neovasculopathy (PNV).
Patients diagnosed between January 2007 and June 2016 at 2 high-volume, tertiary hospitals were retrospectively reviewed with serial multimodal imaging assessment. The primary outcome was the association between drusen subtypes (hard/soft drusen, subretinal drusenoid droplets, or pachydrusen) with CVH and PHS, previously described in central serous chorioretinopathy.
Among the 105 eyes (105 patients; mean age, 67.0 years), 87 (82.9%) were diagnosed with PCV and 18 (17.1%) with PNV. Pachydrusen was the most frequently identified subtype (54 eyes, 51.4%). CVH (72.2% vs 41.4%, P = 0.021) and PHS (72.2% vs 44.8%, P = 0.041) were observed with greater frequency in PNV eyes. Significant correlations were found between CVH and PHS (phi coefficient φ 0.30, P = 0.003), and PHS with pachydrusen (φ 0.20, P = 0.040). Over a mean follow-up of 74.8 months, new drusen co-localizing to PHS were noted in 22 (21.0%) eyes (φ 0.54, P < 0.001).
We observed a trend of pachydrusen appearing in conjunction with PHS in PCV or PNV. Frequent localization of new drusen to these choroidal lesions was observed over long-term follow-up. PHS may be a form of late-staining "forme fruste" drusen, possibly associated with micro-ischemic changes to the choriocapillaris.
研究在多模式成像序列中，大囊样脉络膜血管病变（PCV）或厚脉络膜新生血管病变（PNV）患者的脉络膜血管高通透性（CVH）和点状高荧光斑（PHS）与铜盘样硬性渗出之间的关系。
回顾性分析了 2007 年 1 月至 2016 年 6 月期间在 2 家大型三级医院诊断的患者，这些患者进行了多模态成像序列评估。主要结局是先前在中心性浆液性脉络膜视网膜病变中描述的硬性渗出（硬性/软性渗出、视网膜下硬性渗出样小滴或铜盘样硬性渗出）与 CVH 和 PHS 的关系。
在 105 只眼（105 例患者；平均年龄 67.0 岁）中，87 只眼（82.9%）被诊断为 PCV，18 只眼（17.1%）为 PNV。铜盘样硬性渗出最常见（54 只眼，51.4%）。PNV 眼更常出现 CVH（72.2%比 41.4%，P=0.021）和 PHS（72.2%比 44.8%，P=0.041）。还发现 CVH 与 PHS 之间存在显著相关性（φ 系数 0.30，P=0.003），PHS 与铜盘样硬性渗出之间存在相关性（φ 系数 0.20，P=0.040）。在平均 74.8 个月的随访中，22 只眼（21.0%）新出现的硬性渗出灶与 PHS 共存（φ 系数 0.54，P<0.001）。
我们观察到铜盘样硬性渗出在 PCV 或 PNV 中与 PHS 同时出现的趋势。在长期随访中，这些脉络膜病变上经常出现新的硬性渗出灶。PHS 可能是一种晚期染色的“未定型硬性渗出”，可能与脉络膜毛细血管的微小缺血性改变有关。
