Mukai Ryo, Itagaki Kanako, Honjyo Jyunichiro, Matsumoto Hidetaka, Sekiryu Tetsuju
Department of Ophthalmology, Fukushima Medical University, 1 Hikarigaoka-Cho, Fukushima, 960-1295, Japan.
Department of Ophthalmology, Gunma University Graduate School of Medicine, Maebashi, Japan.
Graefes Arch Clin Exp Ophthalmol. 2023 Dec;261(12):3475-3480. doi: 10.1007/s00417-023-06203-0. Epub 2023 Aug 24.
Posterior vortex vein pulsation on Heidelberg indocyanine green angiography (HRA-IA) video is reported to indicate the presence of congestion in these vessels. This study aimed to determine the relationship between posterior vortex vein pulsation, choroidal thickness, and choroidal vascular hyperpermeability (CVH) in polypoidal choroidal vasculopathy (PCV).
Forty-three eyes of 43 patients who had not received previous treatment and were diagnosed with PCV using multimodal imaging were included and retrospectively investigated. On initial visit, presence or absence of pulsation in the posterior vortex vein was analysed using HRA-IA. Subfoveal choroidal thickness (SFCT) was assessed, and patients were divided into the SFCT ≥ 200 μm and < 200 μm (P and NP, respectively) groups. Presence or absence of CVH was investigated using IA in the late phase, and the associations between the three parameters were analysed.
Posterior vortex vein pulsation was detected in 24/43 eyes (55%). There were 27 eyes in the P group (mean SFCT, 286 ± 48 μm) and 16 eyes in the NP group (mean SFCT, 143 ± 41 μm). Pulsation was detected in 10 eyes (37%) in the P group and 14 eyes (88%) in the NP group. Incidence of pulsation was significantly higher in the NP group (P < 0.05). There were 17 (40%) patients with CVH-13 (48%) and four (25%) in the P and NP groups, respectively (P = 0.1994). There was no correlation between the presence or absence of pulsation and CVH (P = 0.1994).
Congestion of the vortex vein is potentially associated with the pathogenesis of PCV with a thin choroid.
据报道，海德堡吲哚菁绿血管造影（HRA-IA）视频中的后涡静脉搏动表明这些血管存在充血。本研究旨在确定息肉状脉络膜血管病变（PCV）中后涡静脉搏动、脉络膜厚度和脉络膜血管高通透性（CVH）之间的关系。
纳入43例未接受过先前治疗且经多模态成像诊断为PCV的患者的43只眼，并进行回顾性研究。初次就诊时，使用HRA-IA分析后涡静脉是否存在搏动。评估黄斑中心凹下脉络膜厚度（SFCT），并将患者分为SFCT≥200μm组和<200μm组（分别为P组和NP组）。在晚期使用吲哚菁绿血管造影研究是否存在CVH，并分析这三个参数之间的关联。
43只眼中有24只（55%）检测到后涡静脉搏动。P组有27只眼（平均SFCT，286±48μm），NP组有16只眼（平均SFCT，143±41μm）。P组10只眼（37%）检测到搏动，NP组14只眼（88%）检测到搏动。NP组搏动发生率显著更高（P<0.05）。有17例（40%）患者存在CVH，P组和NP组分别有13例（48%）和4例（25%）（P=0.1994）。搏动的有无与CVH之间无相关性（P=0.1994）。
涡静脉充血可能与脉络膜薄的PCV发病机制有关。
