Cohen S Y, Laroche A, Leguen Y, Soubrane G, Coscas G J
Department of Ophthalmology, University of Paris XII, Creteil, France.
Ophthalmology. 1996 Aug;103(8):1241-4. doi: 10.1016/s0161-6420(96)30515-0.
Choroidal neovascularization (CNV) is a common cause of legal blindness in developed countries. In patients younger than 50 years of age, CNV can be due to various causes, but to the authors' knowledge there has been no large epidemiologic study to compare the relative incidence of the various causes of CNV in this younger-aged group.
A retrospective study was performed of patients seen over a 30-month period to precisely define the relative incidence of the various etiologies of CNV in patients younger than 50 years of age who had been referred to a tertiary care ophthalmology department in western Europe.
Clinical charts and angiograms of 363 patients were reviewed. The etiology of CNV was high myopia in 225 (62%) patients, pseudo-presumed ocular histoplasmosis syndrome in 42 (12%), angioid streaks in 17 (5%), and miscellaneous hereditary or traumatic or inflammatory disorders in 16 (4%). Choroidal neovascularization could not be related to any etiology in 63 (17%) patients, and was considered to be idiopathic lesions. Choroidal neovascularization was subfoveal in 62% of the patients due to myopia versus 30% to 36% in patients due to other etiologies. Laser photocoagulation was applied in the majority of patients due to all etiologies except myopia.
These data provide the relative incidence of the various etiologies of CNV in young patients and emphasize the importance of myopia as an etiology of CNV in such patients. In addition, an apparent preferential localization of CNV to the subfoveal region in myopic eyes precludes its treatment with photocoagulation.
脉络膜新生血管（CNV）是发达国家法定失明的常见原因。在50岁以下的患者中，CNV可由多种原因引起，但据作者所知，尚无大型流行病学研究比较该年轻人群中CNV各种病因的相对发病率。
对在30个月期间就诊的患者进行回顾性研究，以精确确定转诊至西欧一家三级眼科护理科室的50岁以下CNV患者各种病因的相对发病率。
回顾了363例患者的临床病历和血管造影片。CNV的病因在225例（62%）患者中为高度近视，42例（12%）为疑似眼组织胞浆菌病综合征，17例（5%）为血管样条纹，16例（4%）为各种遗传性、外伤性或炎性疾病。63例（17%）患者的脉络膜新生血管无法确定病因，被认为是特发性病变。近视患者中62%的脉络膜新生血管位于黄斑中心凹下，而其他病因患者中这一比例为30%至36%。除近视外，大多数病因的患者均接受了激光光凝治疗。
这些数据提供了年轻患者中CNV各种病因的相对发病率，并强调了近视作为此类患者CNV病因的重要性。此外，近视眼中CNV明显优先定位于黄斑中心凹下区域，这使得光凝治疗无法应用于该区域。
