Subfoveal choroidal neovascularization in punctate inner choroidopathy - Surgical management and pathologic findings
Subfoveal choroidal neovascularization in punctate inner choroidopathy - Surgical management and pathologic findings
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DOI：
10.1016/s0161-6420(96)30387-4
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发表时间：
1996-12-01
期刊：
影响因子：
13.7
通讯作者：
Aaberg, TM
中科院分区：
文献类型：
--
作者：
Olsen, TW;Capone, A;Aaberg, TM
目的：评价黄斑下手术治疗点状内部脉络膜病变中的中心凹下脉络膜新生血管，描述切除的视网膜下组织的组织病理学和超微结构，并提出一种表征脉络膜新生血管与相关视网膜下纤维化发展的分期系统，方法：作者回顾了5例（6眼）点状内部脉络膜病变患者的记录，这些患者接受了黄斑下手术治疗中心凹下脉络膜新生血管。手术标本进行了检查，使用光和透射电镜。结果：视力改善，术后注意到在所有6只眼睛，随访时间为8至36个月（中位数，14个月）。复发（6/4眼）是常见的，6例复发中有5例需要额外的手术：3例手术治疗，2例激光光凝治疗，1例观察治疗。脉络膜新生血管的“桥接”导致6只眼中4只出现星状或“哑铃形”视网膜下纤维化区域。组织病理学检查显示有内皮血管、视网膜色素上皮、淋巴细胞、浆细胞、纤维细胞、胶原碎片，很少有视网膜外膜。结论：点状内部脉络膜病变的中心凹下脉络膜新生血管可以通过黄斑下手术治疗，复发是常见的，并可能导致严重的视力丧失。伴随纤维化反应的脉络膜新生血管膜是视网膜下纤维化的星状或哑铃形区域的原因，使用皮质类固醇治疗脉络膜新生血管没有表现出有益效果。
Purposes: To evaluate submacular surgery for the management of subfoveal choroidal neovascularization in punctate inner choroidopathy, to describe the histopathology and ultrastructure of the excised subretinal tissue, and to propose a staging system that characterizes the development of choroidal neovascularization with associated subretinal fibrosis,Methods: The authors reviewed the records of five patients (6 eyes) with punctate inner choroidopathy who underwent submacular surgery for subfoveal choroidal neovascularization. Surgical specimens were examined using light and transmission electron microscopy.Results: Visual improvement was noted postoperatively in all six eyes, with follow-up ranging from 8 to 36 months (median, 14 months). Recurrences (6 in 4 eyes) were common, Five of the six recurrences required additional procedures: three were managed surgically, two with laser photocoagulation, and one with observation. ''Bridging'' of separate foci of choroidal neovascularization resulted in stellate or ''dumbbell-shaped'' areas of subretinal fibrosis in four of six eyes. Histopathologic evaluation of the excised tissue showed endothelial-lined vascular channels, retinal pigment epithelium, lymphocytes, plasma cells, fibrocytes, collagen fragments, and rarely, outer retinal elements,Conclusions: Subfoveal choroidal neovascularization in punctate inner choroidopathy may be managed with submacular surgery, Recurrences are common and may result in substantial loss of vision. Choroidal neovascular membranes with an accompanying fibrotic reaction are responsible for the stellate or dumbbell-shaped areas of subretinal fibrosis, No beneficial effect was demonstrated using corticosteroid treatment of the choroidal neovascularization.