渗出型老年性黄斑变性与息肉状脉络膜血管病变眼底造影的对比分析

目的对比分析渗出型老年性黄斑变性（AMD）与息肉状脉络膜血管病变（PCV）眼底造影表现的异同。方法回顾性分析渗出型AMD患者98例119只眼及PCV患者61例68只眼的荧光素眼底血管造影（FFA）和吲哚青绿血管造影（ICGA）检查资料。结果 119只渗出型AMD患眼中,眼底彩照和FFA显示21只眼为经典型脉络膜新生血管（CNV）,占17.6%;29眼为微小经典型CNV,占24.4%;69眼诊断为隐匿型CNV,占58%;6只眼CNV与PCV共存,占5%。68只PCV眼中,54只眼荧光素眼底ICGA显示有异常分支的脉络膜血管网及其末梢的息肉状扩张、膨隆灶,占79.4%;14只眼见多个息肉状脉络膜血管扩张灶但无明显的分支状脉络膜血管网与之相连,占20.6%。造影后期部分息肉状病灶染料渗漏或染色,部分呈息肉状病灶中心为弱荧光,周围环状染色的＂冲刷现象＂。在疑似PCV的患者中,有90例行ICGA,确诊PCV 61例,占67.8%;PCV约占渗出性AMD的36.36%。结论渗出型AMD与PCV不同的ICGA表现,有助于两者的诊断与鉴别诊断。

Characteristics of the angiography of exudative age-related macular degeneration and polypoidal choroidal vasculopathy

Objective To compare the characteristics of the angiography of exudative age-related macular degeneration（AMD） with polypoidal choroidal vasculopathy（PCV）.Methods 98 patients（119 eyes） with exudative AMD and 61 patients（68 eyes） with PCV diagnosed by fundus fluorescein angiography（FFA）,and indocyanine green angiography（ICGA） were retrospectively analyzed.Results In 119 eyes with,21 eyes（17.6%） had classic neovascularization（CNV）,69 eyes（58%） had occult CNV.6 eyes（5%） had CNV with PCV in ICGA.In 68 eyes with PCV,54 eyes（79.4%） demonstrated polypoidal dilations with branching vascular network,and 14 eyes（20.6%） showed scattered polypoidal dilations without identifiable continuous branching vascular network,the polypoidal dilations showed either a washout of the dye from the polyp with staining of its walls or staining of the dye in the late phase of ICGA.There were 90 patients with exudative AMD,in which 61 patients were with PCV（67.8%）.Conclusion About 36.36% exudative age-related macular degeneration are polypoidal choroidal vasculopathy.The different features of exudative AMD and PCV in the ICGA are useful in the differentiate diagnosis of the both diseases.