PACHYCHOROID NEOVASCULOPATHY
PACHYCHOROID NEOVASCULOPATHY
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DOI：
10.1097/iae.0000000000000331
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发表时间：
2015-01-01
影响因子：
3.3
通讯作者：
Freund, K. Bailey
中科院分区：
文献类型：
--
作者：
Pang, Claudine E.;Freund, K. Bailey
目的：报告3例厚脉络膜新生血管病，（视网膜下色素上皮）新血管形成，发生在脉络膜厚度增加和脉络膜血管扩张的区域上。一项回顾性观察病例系列，包括三名接受全面眼科检查和多模式成像（包括眼底摄影、眼底自发荧光、谱域光学相干断层扫描）的患者，结果：3例患者（年龄55 ~ 63岁）的3只眼，增强型深度成像光学相干断层扫描（OCT）均发现1型新生血管覆盖在脉络膜增厚和扩张的脉络膜血管上。用吲哚菁绿色血管造影，在所有三只眼睛的新生血管组织区域下方均可见脉络膜大静脉和脉络膜通透性过高。没有眼睛有黄斑下渗出性脱离或自发荧光改变的证据，以表明先前的急性或慢性中心性浆液性脉络膜视网膜病变。没有眼睛有玻璃疣或退行性变化，提示年龄相关性黄斑变性或其他退行性疾病。在1例患者中，对侧未受影响的眼睛表现出视网膜色素上皮异常，最佳表现为眼底自发荧光，增强深度成像光学相干断层扫描显示覆盖局灶性扩张的脉络膜血管，吲哚菁绿色血管造影显示相关的脉络膜通透性过高，与厚脉络膜色素上皮病的诊断一致。所有三只眼睛都显示了新生血管组织内息肉样结构的外观。厚膜脉络膜新生血管病福尔斯属于与脉络膜增厚相关的疾病谱，包括厚膜脉络膜色素上皮病，中心性浆液性脉络膜视网膜病，和息肉状脉络膜血管病变，在缺乏特征性脉络膜增厚和1型新生血管的情况下，老年性黄斑变性或退行性改变。厚性脉络膜新生血管病变可能发生在黄斑内的局灶性异常，即使在中心凹下脉络膜厚度正常的近视眼中也是如此。厚膜脉络膜血管病变最终可发展为息肉状脉络膜血管病变。
Purpose: To report 3 cases of pachychoroid neovasculopathy, a form of Type 1 (subretinal pigment epithelium) neovascularization, occurring over areas of increased choroidal thickness and dilated choroidal vessels.Methods: A retrospective observational case series of three patients who underwent comprehensive ophthalmic examination and multimodal imaging with fundus photography, fundus autofluorescence, spectral domain optical coherence tomography, enhanced depth imaging optical coherence tomography, fluorescein angiography, and indocyanine green angiography.Results: In all 3 eyes of 3 patients, aged 55 years to 63 years, there was Type 1 neovascularization overlying a localized area of choroidal thickening and dilated choroidal vessels seen with enhanced depth imaging optical coherence tomography. With indocyanine green angiography, there were large choroidal veins and choroidal hyperperme-ability seen beneath the area of the neovascular tissue in all three eyes. No eyes had evidence of submacular exudative detachment or autofluorescence changes to suggest antecedent acute or chronic central serous chorioretinopathy. No eyes had drusen or degenerative changes to suggest age-related macular degeneration or other degenerative diseases. In one patient, the fellow unaffected eye demonstrated retinal pigment epithelium abnormalities, best seen with fundus autofluorescence, overlying focal dilated choroidal vessels seen with enhanced depth imaging optical coherence tomography and associated choroidal hyperpermeability seen with indocyanine green angiography, consistent with the diagnosis of pachychoroid pigment epitheliopathy. All three eyes showed the appearance of polypoidal structures within the neovascular tissue.Conclusion: Pachychoroid neovasculopathy falls within a spectrum of diseases associated with choroidal thickening that includes pachychoroid pigment epitheliopathy, central serous chorioretinopathy, and polypoidal choroidal vasculopathy and should be considered as a possible diagnosis in eyes with features of Type 1 neovascularization and choroidal thickening in the absence of characteristic age-related macular degeneration or degenerative changes. Pachychoroid neovasculopathy may occur as a focal abnormality within the macula, even in myopic eyes with normal subfoveal choroidal thickness. Pachychoroid neovasculopathy can ultimately progress to the development of polypoidal choroidal vasculopathy.