PACHYCHOROID PIGMENT EPITHELIOPATHY
PACHYCHOROID PIGMENT EPITHELIOPATHY
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DOI：
10.1097/iae.0b013e3182953df4
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发表时间：
2013-09-01
影响因子：
3.3
通讯作者：
Freund, K. Bailey
中科院分区：
文献类型：
--
作者：
Warrow, David J.;Hoang, Quan V.;Freund, K. Bailey
目的：报告9例厚脉络膜色素上皮病。方法：对9例患者进行综合眼科检查、眼底照相、眼底自发荧光、光谱域光学相干断层扫描和增强深度光学相干断层扫描。结果：9例18眼患者，年龄27~89岁，根据眼底镜下表现为眼底减少伴一眼或双眼视网膜色素上皮改变、眼底自身荧光异常、增强深度成像光学相干断层扫描证实黄斑下脉络膜厚度增加(平均460.2 mU)，诊断为厚脉络膜色素上皮病。这五名年长的患者之前被诊断为年龄相关性黄斑变性，而四名年轻的受试者被转诊为可能的炎症性脉络膜视网膜炎、图案营养不良或非特异性玻璃体病变。无视网膜下积液病史。结论：厚脉络膜色素上皮病变属于脉络膜增厚相关疾病的范畴，包括中心性浆液性脉络膜视网膜病变和息肉状脉络膜血管病变，其眼底表现与脉络膜增厚和相关的视网膜色素上皮异常有关，但无视网膜下积液病史，应予以怀疑。增强的深度成像光学相干断层扫描证实了异常增厚的脉络膜和眼底有特征性的视网膜色素上皮改变，支持这一诊断。由于这些患者经常被误诊，认识到厚脉络膜色素上皮病可能会避免不必要的诊断测试和干预。
Purpose: To report nine cases of pachychoroid pigment epitheliopathy.Methods: An observational case series of nine patients who underwent comprehensive ophthalmic examination, fundus photography, fundus autofluorescence, spectral-domain optical coherence tomography, and enhanced depth imaging optical coherence tomography.Results: Eighteen eyes of 9 patients, aged 27 years to 89 years, were diagnosed with pachychoroid pigment epitheliopathy based on the characteristic funduscopic appearance of reduced fundus tessellation with overlying retinal pigment epithelial changes in one or both eyes, fundus autofluorescence abnormalities, and increased subfoveal choroidal thickness confirmed by enhanced depth imaging optical coherence tomography (mean, 460.2 mu m). The five older patients had been previously diagnosed with age-related macular degeneration, while the four younger subjects were referred for possible inflammatory chorioretinitis, pattern dystrophy, or nonspecific drusen. No subjects had a history of or subsequently developed subretinal fluid.Conclusion: Pachychoroid pigment epitheliopathy falls within a spectrum of diseases associated with choroidal thickening that includes central serous chorioretinopathy and polypoidal choroidal vasculopathy, and it should be suspected in eyes with a characteristic fundus appearance related to choroidal thickening and associated retinal pigment epithelial abnormalities but no history of subretinal fluid. Enhanced depth imaging optical coherence tomography confirming an abnormally thick choroid and characteristic retinal pigment epithelial changes on fundus autofluorescence support the diagnosis. Because these patients are frequently misdiagnosed, the recognition of pachychoroid pigment epitheliopathy may avoid unnecessary diagnostic testing and interventions.