Pigment epithelial detachment in polypoidal choroidal vasculopathy
Pigment epithelial detachment in polypoidal choroidal vasculopathy
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DOI：
10.1016/j.ajo.2006.08.025
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发表时间：
2007-01-01
影响因子：
4.2
通讯作者：
Yoshimura, Nagahisa
中科院分区：
文献类型：
--
作者：
Tsujikawa, Akitaka;Sasahara, Manabu;Yoshimura, Nagahisa
目的：研究息肉状脉络膜血管病(PCV)伴发息肉样病变的浆血性色素上皮脱离(PED)的形态特征。设计：回顾性观察病例系列。方法：对85例(93只眼)PCV患者的连续观察病例进行回顾性分析。采用吲哚青绿血管造影(IA)和光学相干断层扫描(OCT)对PCV的病变进行检查。结果：93只眼PCV中51只眼(55%)有浆液性或出血性PED。在这51只眼中，血管造影术发现27只眼(53%)PED有切迹，其中大多数在IA上显示息肉样病变，其位置与血管造影术观察到的切迹位置相一致。息肉样病变位于PED外1眼(2%)，PED边缘33眼(65%)，PED内12眼(24%)。OCT显示29只眼(57%)在断层扫描上发现有切迹，其中大部分与IA所见的息肉样病变的位置相对应。在8只眼中，息肉样病变附着在浆液性PED的内表面，与Bruch膜和脉络膜分离。结论：息肉样病变位于PED的边缘，在伴发的PED上形成一个凹槽，血管造影和断层扫描可见。当息肉样病变的渗出液增加时，病变的积液渗入息肉样病变下面，导致病变脱离Bruch膜，看起来像位于PED内。
PURPOSE: To study the morphological features of serosanguineous pigment epithelial detachments (PEDs) with accompanying polypoidal lesions in eyes with polypoidal choroidal vasculopathy (PCV).DESIGN: Retrospective observational case series.METHODS: For this observational case study, we retrospectively reviewed 93 consecutive eyes of 85 patients with PCV. The lesions in eyes with PCV were examined with indocyanine green angiography (IA) and optical coherence tomography (OCT).RESULTS: Of 93 eyes with PCV, 51 eyes (55%) had serous or hemorrhagic PEDs. Of these 51 eyes, a notch in the PED was found in 27 eyes (53%) by angiography, most of which showed polypoidal lesions by IA that corresponded in location to the notch observed by angiography. Polypoidal lesions were detected outside the PED in one eye (2%), at the margin of the PED in 33 eyes (65%), and inside the PED in 12 eyes (24%). OCT revealed that PED had a notch observed tomographically in 29 eyes (57%), most of which corresponded in location to polypoidal lesions seen by IA. In eight eyes, polypoidal lesions, which were adherent to the inner surface of the serous PED, appeared to be detached from the Bruch membrane and the choroid.CONCLUSIONS: Polypoidal lesions are located at the margin of PED and make a notch in the accompanying PED that is visible by angiography and tomographically. When the polypoidal lesions have increased exudate, the fluid from the lesions infiltrates under the polypoidal lesions themselves, which results in the lesions detaching from the Bruch membrane and appearing to be located inside the PED.