Pathogenesis of polypoidal choroidal vasculopathy focusing on the extracellular matrix

[背景与目的]息肉状脉络膜血管病(PCV)以脉络膜血管分支伴息肉样终末动脉瘤扩张为特征。临床表现为脉络膜内血管异常，由息肉状血管和分支血管网两个基本成分组成。尽管众所周知，PCV偏爱于亚洲人群，但其确切的病理机制仍不清楚，目前也没有治疗指南。[结果]1.脉络膜血管的特征(1)脉动血流我们回顾了一系列伴有搏动性息肉样血管的PCV病例，并评价了PCV中此类血管的特征。这是一种独特而重要的特征，在任何其他脉络膜视网膜疾病中都没有报道过。(2)PCV的多样性我们从LE…的角度研究了PCV的临床特征更多的血管大小和疾病持续时间，在疾病的早期和晚期，并发现组之间的差异。结果提示，PCV可能存在亚群；这些亚群的基础或不同的病理，但表现出相似的息肉结构。对小短病例的长期观察可以消除他的不确定性。还需要结合病理学和治疗的进一步研究。曲安奈德(TA)注射治疗渗出型老年性黄斑变性/PCV的疗效我们评价了玻璃体腔/Tenon下注射TA治疗渗出型老年性黄斑变性(AMD/PCV)的疗效。玻璃体内注射TA可在短期内改善渗出型AMD患者的视力和眼底表现，且无明显副作用，如眼压升高和眼内炎。(眼科，220：118-24,2006)从有效性、安全性和成本的角度来看，Trans-Tenon球后注射TA可能是治疗PCV的一种潜在选择。(Graefe的临床和实验眼科档案，243：837-9,2005)

[Background and Purpose]Polypoidal choroidal vasculopathy (PCV) is characterized by branching choroidal vessels with polyp-like terminal aneurismal dilations. Clinically, the vascular abnormality appears to be in the inner choroid and is composed of 2 basic elements: a polypoidal vessel and a branching vascular network. Although PCV is known to have a predilection for Asian populations, the exact pathology of it remains unclear and there are no current treatment guidelines. In this study, we aimed to evaluate choroidal vasculature and find efficient treatments for patients with PCV.[Results]1. Features o: vessels in PCV(1) Pulsatile blood flowWe reviewed our series of cases of PCV with pulsatile polypoidal vessels and evaluated the features of such vessels in PCV. it is a unique and important characteristic that has not been reported with any other chorio-retinal diseases. (Ophthalmology, 112:1436-41, 2005)(2) Diversity in PCVWe investigated the clinical features of PCV, in terms of le … More sion size and disease duration, during earlier and later disease stages and found differences between the groups. The results suggest that there may be subgroups in PCV; these subgroups are based or different pathologies but manifest similar polypoidal structures. Long-term observation of small-short cases could resolve his uncertainty. Further studies incorporating pathologies and treatments are required. (submitted)2. Effect of Injection of triamcinolone acetonide (TA) for exudative age related macular degeneration / PCVWe evaluated the effect of intravitreal / sub-Tenon TA with exudative age related macular degeneration (AMD)/ PCV. Intravitreal TA provided short-term improvement in visual acuity and fundus findings in exudative AMD without significant side effects such as intraocular pressure increase and endophthalmitis. (Ophthalmologica, 220:118-24, 2006)Trans-Tenon's retrobulbar TA injection may be a potential option for treating PCV from the point of view of effectiveness, safety, and cost. (Graefe's Archive for Clinical and Experimental Ophthalmology, 243:837-9, 2005) Less