Moorthy R S, Lyon A T, Rabb M F, Spaide R F, Yannuzzi L A, Jampol L M
Department of Ophthalmology, Northwestern University Medical School, Chicago, IL 60611, USA.
Ophthalmology. 1998 Aug;105(8):1380-5. doi: 10.1016/S0161-6420(98)98016-2.
The authors evaluated the clinical, fluorescein, and indocyanine green (ICG) angiographic characteristics of the macular variant of idiopathic polypoidal choroidal vasculopathy (IPCV).
Observational case series.
The records, photographs, and fluorescein and ICG angiograms of eight eyes of seven patients with IPCV lesions confined to the macula were reviewed.
The visual acuity, fundus examination, fluorescein and ICG angiographic characteristics, and clinical course were compared.
All patients demonstrated polypoidal lesions arising from macular choroidal vessels on ICG angiography. One patient had bilateral lesions. These lesions appeared hyperfluorescent in the early phases of both fluorescein and ICG angiography. Late-phase leakage was seen in cases associated with subretinal fluid or exudate. None of these patients demonstrated polypoidal lesions arising from the peripapillary choroidal circulation or peripapillary choroidal neovascularization. Three eyes with polypoidal lesions that were associated with subretinal fluid and exudates were treated with photocoagulation. Five eyes were not treated. Final visual acuity ranged from 20/20 to hand motions. Severe visual loss was associated with vitreous and subretinal hemorrhage, but this resolved without permanent severe visual loss in several cases.
In the macular variant of IPCV, ICG and fluorescein angiography demonstrate characteristic macular polypoidal lesions without evidence of peripapillary lesions. The vascular origin of these polypoidal lesions appears to be the macular choroidal circulation. This is distinguished from classic IPCV, in which lesions appear to arise from the peripapillary choroidal circulation. Visual prognosis appears to be good, with most patients retaining visual acuity of 20/80 or better. If subretinal fluid or exudates reduce visual acuity, photocoagulation should be considered.
作者评估了特发性息肉状脉络膜血管病变（IPCV）黄斑变型的临床、荧光素及吲哚菁绿（ICG）血管造影特征。
观察性病例系列。
回顾了7例IPCV病变局限于黄斑的患者8只眼的病历、照片以及荧光素和ICG血管造影片。
比较视力、眼底检查、荧光素和ICG血管造影特征及临床病程。
所有患者在ICG血管造影中均显示黄斑脉络膜血管出现息肉样病变。1例患者为双侧病变。这些病变在荧光素和ICG血管造影的早期均表现为高荧光。在伴有视网膜下液或渗出的病例中可见晚期渗漏。这些患者均未显示视乳头周围脉络膜循环或视乳头周围脉络膜新生血管形成的息肉样病变。3只伴有视网膜下液和渗出的息肉样病变眼接受了光凝治疗。5只眼未治疗。最终视力范围从20/20到手动。严重视力丧失与玻璃体和视网膜下出血有关，但在一些病例中这种情况得到缓解，未出现永久性严重视力丧失。
在IPCV黄斑变型中，ICG和荧光素血管造影显示特征性的黄斑息肉样病变，无视乳头周围病变的证据。这些息肉样病变的血管起源似乎是黄斑脉络膜循环。这与经典的IPCV不同，经典IPCV的病变似乎起源于视乳头周围脉络膜循环。视力预后似乎良好，大多数患者的视力保持在20/80或更好。如果视网膜下液或渗出物降低了视力，应考虑光凝治疗。
