Idiopathic polypoidal choroidal vasculopathy of the macula
Idiopathic polypoidal choroidal vasculopathy of the macula
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DOI：
10.1016/s0161-6420(98)98016-2
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发表时间：
1998-08-01
期刊：
影响因子：
13.7
通讯作者：
Jampol, LM
中科院分区：
文献类型：
--
作者：
Moorthy, RS;Lyon, AT;Jampol, LM
目的：评价黄斑型特发性息肉状脉络膜血管病(IPCV)的临床、荧光素和吲哚青绿(ICG)血管造影特征。设计：观察病例系列。参与者：回顾7例8眼局限于黄斑部的IPCV病变的记录、照片、荧光素和ICG血管造影。主要观察指标：视力、眼底检查、荧光素和ICG血管造影特征以及临床病程。结果：所有患者ICG血管造影均显示黄斑脉络膜血管息肉样病变。1例患者有双侧病变。这些病变在荧光素和ICG血管造影术的早期阶段都表现为强荧光。晚期渗漏见于视网膜下积液或渗出液。这些患者中无一例表现为乳头周围脉络膜循环或乳头周围脉络膜新生血管所致的息肉样病变。对3只伴有视网膜下积液和渗出物的息肉状病变的患者进行了光凝治疗。5只眼未接受治疗。最终视力从20/20到手部运动。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，这种情况在没有永久性严重视力丧失的情况下得到缓解。结论：在黄斑变异型IPCV中，ICG和荧光素血管造影显示典型的黄斑息肉样病变，但没有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，在IPCV中，病变似乎起源于乳头周围脉络膜循环。视力预后良好，大多数患者的视力保持在20/80或更高。如果视网膜下积液或渗出物降低视力，应考虑光凝治疗。
Objective: The authors evaluated the clinical, fluorescein, and indocyanine green (ICG) angiographic characteristics of the macular variant of idiopathic polypoidal choroidal vasculopathy (IPCV).Design: Observational case series.Participants: The records, photographs, and fluorescein and ICG angiograms of eight eyes of seven patients with IPCV lesions confined to the macula were reviewed.Main Outcome Measures: The visual acuity, fundus examination, fluorescein and ICG angiographic characteristics, and clinical course were compared.Results: 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.Conclusions: 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.