Zhang Yining, Li Miaoling, He Guiqin, Gan Yuhong, Zhuang Xuenan, Chen Xuelin, Pu Jiaxin, Su Yongyue, Hao Xinlei, Wen Feng
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
Transl Vis Sci Technol. 2025 Sep 2;14(9):7. doi: 10.1167/tvst.14.9.7.
To investigate the spatial relationship between choroidal vortex veins (VVs), choroidal watershed zones (CWZs), and polypoidal lesion distribution in different subtypes of polypoidal choroidal vasculopathy (PCV) categorized by choroidal vascular hyperpermeability (CVH) status.
This retrospective study analyzed 58 treatment-naïve PCV eyes using widefield imaging to map dominant VVs, CWZs, and lesion locations. Eyes were stratified into CVH (n = 32) and non-CVH (n = 26) groups. Comparative analyses were performed to evaluate the differences between PCV eyes and their unaffected fellow eyes, as well as between CVH and non-CVH eyes.
PCV eyes demonstrated significantly increased numbers of dominant VVs (P = 0.001) and temporal VV predominance (P = 0.039) compared to fellow eyes. Lesion distribution patterns differed significantly between CVH and non-CVH groups (P = 0.04). Although 71.8% of lesions (112/156) localized to dominant VV quadrants in both groups, CVH eyes showed greater CWZ involvement (23.9% vs. 10.3% in non-CVH; P = 0.029).
The findings indicate that choroidal venous architecture and CVH-driven pathological changes may contribute synergistically to PCV pathogenesis, highlighting the interplay between anatomical vulnerability and pathological processes in PCV development.
This study links choroidal VV distribution to PCV lesion localization, enabling risk-stratified imaging protocols. The CVH-specific CWZ involvement further guides personalized monitoring and hemodynamic-targeted adjuvant therapies.
研究脉络膜涡静脉（VVs）、脉络膜分水岭区（CWZs）与按脉络膜血管高通透性（CVH）状态分类的不同亚型息肉样脉络膜血管病变（PCV）中息肉样病变分布之间的空间关系。
这项回顾性研究分析了58只未经治疗的PCV患眼，使用广角成像来绘制主要VVs、CWZs和病变位置。将患眼分为CVH组（n = 32）和非CVH组（n = 26）。进行比较分析以评估PCV患眼与其未受影响的对侧眼之间以及CVH组和非CVH组之间的差异。
与对侧眼相比，PCV患眼的主要VVs数量显著增加（P = 0.001），且颞侧VVs占优势（P = 0.039）。CVH组和非CVH组之间的病变分布模式有显著差异（P = 0.04）。尽管两组中71.8%的病变（112/156）位于主要VVs象限，但CVH患眼中CWZ受累更多（非CVH组为10.3%，CVH组为23.9%；P = 0.029）。
研究结果表明，脉络膜静脉结构和CVH驱动的病理变化可能协同促进PCV的发病机制，突出了解剖易损性与PCV发展中病理过程之间的相互作用。
本研究将脉络膜VVs分布与PCV病变定位联系起来，实现风险分层成像方案。CVH特异性的CWZ受累进一步指导个性化监测和血流动力学靶向辅助治疗。
