Tsujikawa M, Sawa M, Lewis J M, Motokura M, Tsujikawa K, Ohji M, Saito Y, Tano Y
Department of Ophthalmology, Osaka University Medical School, Japan.
Am J Ophthalmol. 1998 Sep;126(3):348-57. doi: 10.1016/s0002-9394(98)00089-0.
To determine whether choroidal neovascularization excision causes mechanical damage to the neurosensory retina, retinal pigment epithelium, or choriocapillaris.
Prospectively, 18 eyes of 18 consecutive patients who underwent choroidal neovascularization excision were observed. Preoperatively and postoperatively, the integrity of the choriocapillaris circulation in the pathway of choroidal neovascularization extraction was studied by fluorescein and indocyanine green angiography. Using static scanning laser ophthalmoscope microperimetry, the presence of iatrogenic scotomas that developed postoperatively in the pathway of choroidal neovascularization extraction was also investigated.
Postoperatively, a choriocapillaris defect was detected in 17 (94.4%) of 18 cases. In 15 cases (83.3%), the choriocapillaris defect had a clear relationship to the pathway of choroidal neovascularization extraction. Postoperatively, a scotoma was present in 16 (88.9%) of 18 cases. In 14 cases (77.8%), the location of the scotoma had a clear relationship to the pathway of choroidal neovascularization extraction.
Surgical excision of choroidal neovascularization leads to severe damage of the choroid and retina in the pathway of the extracted choroidal neovascularization. The injury involves the neurosensory retina, retinal pigment epithelium, and choriocapillaris.
确定脉络膜新生血管切除是否会对神经感觉视网膜、视网膜色素上皮或脉络膜毛细血管造成机械性损伤。
前瞻性观察18例连续接受脉络膜新生血管切除患者的18只眼。术前和术后，通过荧光素和吲哚菁绿血管造影研究脉络膜新生血管切除路径中脉络膜毛细血管循环的完整性。使用静态扫描激光检眼镜微视野计，还研究了脉络膜新生血管切除路径术后出现的医源性暗点情况。
术后，18例中的17例（94.4%）检测到脉络膜毛细血管缺损。15例（83.3%）中，脉络膜毛细血管缺损与脉络膜新生血管切除路径有明确关系。术后，18例中的16例（88.9%）出现暗点。14例（77.8%）中，暗点位置与脉络膜新生血管切除路径有明确关系。
脉络膜新生血管的手术切除会导致所切除脉络膜新生血管路径中的脉络膜和视网膜严重损伤。损伤累及神经感觉视网膜、视网膜色素上皮和脉络膜毛细血管。
