特发性眼底血管样条纹的临床特征

目的分析特发性眼底血管样条纹的临床特征。方法分析13例（26眼）特发性眼底血管样条纹患者的临床表现、荧光素眼底血管造影（FFA）及黄斑区光学相干断层扫描（OCT）表现。结果11眼视力≤0.3,占42.31%。26眼眼底后极部均可见类似血管样的放射状条纹,5眼为斑驳状外观,占19.23%;17眼条纹通过黄斑,占65.38%;1眼（3.8%）合并眼外伤致多发性脉络膜破裂出血。FFA显示26眼血管样条纹均表现为透见荧光,11眼黄斑区可见脉络膜新生血管（CNV）影,其亮度逐渐增强,后期有明显的荧光素渗漏。黄斑区OCT检查发现11眼有CNV表现。Ⅰ型CNV（生长于RPE光带下）：表现为在隆起的视网膜色素上皮（RPE）和脉络膜毛细血管层光带下有不均匀的中或高反射带;混合型CNV：表现为CNV侵入RPE光带及视网膜神经上皮层下空间,RPE光带中断,呈现边界不清的高反射组织。结论眼底、FFA及OCT典型表现的综合分析有助于特发性眼底血管样条纹的诊断、分期及治疗指导。

Clinical manifestations of idiopathic angioid streaks

Background Idiopathic angioid streaks shows the specific findings in fundus.It impacts the visual acuity once occur the damage of macular area.Its etiology is unclear.ObjectiveThe present study is to investigate the clinical findings of idiopathic angioid streaks.MethodsTwenty-six eyes from 13 patients with bilateral idiopathic angioid streaks were examined including the routine ophthalmological examination,fluorescence fundus angiography（FFA） and optical coherence tomography（OCT） and color fundus photographs.The clinical characteristics of idiopathic angioid streaks were analyzed.ResultsIn 26 eyes with idiopathic angioid streaks,11 eyes showed the vision acuity ≤0.3（42.31%）.The angioid streaks were visualized in the posterior pole of all the 26 eyes,and 5 eyes（19.23%） were mottled fundus.The macular areas in 17 eyes（65.38%） presented the subretinal hemorrhages or neovascularization,and 1 eye（3.8%） showed the retinal hemorrhage because of trauma.FFA revealed the hyperfluorescence in the streaks of 26 eyes,and 11 eyes of them existed well-defined choroidal neovascularization（CNV）.Hyperfluorescence was seen in venous of macula in the late phase of FFA in most cases.OCT of macular exhibited the CNV in 11 eyes.The CNV were classified into two types according to the location of CNV.Type Ⅰ of CNV located at the level of retinal pigment epithelium（RPE） or sub-RPE,and the type Ⅱof CNV（mixed CNV） located at RPE layer or super RPE.ConclusionThe comprehensive evaluation of typical clinical finding,FFA and OCT results is helpful for the diagnosis,treatment and prognosis for patients with angioid streaks.