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特发性息肉状脉络膜血管病变 总被引:2,自引:2,他引:0
特发性息肉状脉络膜血管病变(idiopathic polypoidal choroidal vasculopathy, IPCV)是近年认识的一种与渗出型老年黄斑变性(age-related macular degeneration, AMD)表现较为相似的眼病,但两种疾病在流行病学、病情转归、视力预后及治疗等方面均有较大的不同。因此IPCV诊断及鉴别诊断具有较为重要的临床意义。IPCV的吲哚青绿血管造影(indocyanine green angiography,ICGA)显示有分支状脉络膜血管网及末梢的息肉状血管扩张等特征性表现,为IPCV诊断与鉴别诊断提供了重要的依据。
(中华眼底病杂志, 2002, 18: 310-312) 相似文献
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特发性息肉状脉络膜血管病变 (idiopathicpoly poidalchoroidalvasculopathy ,IPCV) ,以往〔1〕称之为后部葡萄膜出血综合症或黑人女性多发反复出血性浆液性视网膜色素上皮脱离。 1994年 ,Yannuzzi等〔2〕首次把 11例 4 0~ 70岁患者出现的视网膜下血管息肉状改变导致的视网膜色素上皮严重出血性脱离 ,黄斑功能障碍的疾病命名为IPCV。十年来 ,IPCV的报道逐渐增多 ,对IPCV的认识也逐步深入 ,我们在此做一简要介绍。一、流行病学意大利学者Scassallati -Sforzolini等〔3〕回顾分析了 5 0岁以上共 194例曾诊为老年黄斑变性 (age -re la… 相似文献
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息肉样脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)特征是后极部视网膜下桔红色息肉样病变,伴有出血性和浆液性视网膜色素上皮及神经上皮脱离.荧光素眼底血管造影无特征性表现,吲哚青绿血管造影能显示分支血管组成的脉络膜血管网和血管末端息肉样或动脉瘤样扩张.OCT表现为视网膜色素上皮及脉络膜毛细血管高反射层呈陡峭的穹窿状隆起,其下见中等反射或结节状改变.本病应与湿性年龄相关性黄斑变性和某些长期不愈的中心性浆液性脉络膜视网膜病变进行鉴别.尽管PCV的治疗仍缺乏通用的方案,光动力疗法结合玻璃体内注射血管内皮生长因子抑制剂可改善或稳定患者视力. 相似文献
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息肉状脉络膜血管病变与新生血管性年龄相关性黄斑病变表现较为相似,但二者在流行病学特点、预后及治疗反应等方面均有所不同。吲哚青绿血管造影为息肉状脉络膜血管病变诊断的金标准,光学相干断层扫描进一步提供了其病变的立体影像。临床上息肉状脉络膜血管病变可以采用激光光凝、经瞳孔温热疗法、光动力治疗、抗血管内皮细胞生长因子药物注射、激素注射等治疗措施,疗效不一。现对息肉状脉络膜血管病变诊断、治疗进展及预后做一综述。 相似文献
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目的探讨息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)眼底影像特征。方法回顾性分析PCV患者32例(32眼)的眼底检查资料,所有患者均经荧光素眼底血管造影、吲哚青绿血管造影和光学相干断层扫描(optical coherence tomography,OCT)检查确诊。结果 32眼中6眼表现为异常分支状脉络膜血管网,异常血管网造影后期荧光逐渐减弱;21眼表现为不同程度的息肉状脉络膜血管扩张灶,在造影早期呈囊袋样或结节样强荧光,造影后期表现为渗漏、染色、冲刷现象或者消退;5眼表现为PCV与脉络膜新生血管共同存在。表现为异常分支状脉络膜血管网的6眼OCT检查发现视网膜色素上皮及视网膜色素上皮下的两层强反射,即双层征;而表现为息肉状脉络膜血管扩张灶的26眼OCT检查发现脉络膜内层的突兀状结节样隆起,隆起的下面有中等反射存在。结论 PCV在吲哚青绿血管造影和OCT检查中有其特征性眼底影像表现,掌握这些特点有助于与湿性年龄相关性黄斑变性相鉴别,对患者预后的判断和治疗方法的选择都具有重要的临床意义。 相似文献
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有关息肉状脉络膜血管病诊治的讨论 总被引:1,自引:0,他引:1
息肉状脉络膜血管病变(PCV)以视网膜下橘红色结节样病灶和异常分支状脉络膜血管网及其末梢的息肉状脉络膜血管扩张灶为特征,是亚洲人较常见的一种眼底疾病,由于PCV的临床表现与湿性年龄相关性黄斑变性(AMD)相似,临床上常将其诊断为湿性型AMD,但两者在吲哚青绿血管造影、病程预后及治疗上有较大的差异。进一步提高对PCV诊治的认识,将其从湿性型AMD中分离出来,无论对PCV还是湿性型AMD的治疗均具有重要的临床意义。(眼科,2007,16:373-375,377) 相似文献
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息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)是一种以特异分支状脉络膜血管网及其末梢的息肉状脉络膜血管扩张灶为特征的血管性病变,迄今为止其发病原因和发病机制仍不明确。PCV是一种受环境和多种遗传因素共同作用的结果。近年来,PCV的遗传学研究取得的进展为揭示该病的分子机制奠定了良好基础。研究发现,许多基因均与PCV的发生和发展密切关联。然而,这些研究在不同的种族、国家,甚至同一国家不同地区或不同民族的人群中得到的结果并不一致。现对这些基因与PCV的相关性研究进行综述。 相似文献
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息肉状脉络膜血管病变的分类研究 总被引:2,自引:0,他引:2
目的:在较大样本病例的基础上,探讨息肉状脉络膜血管病变(polypoidalchoroidalvasculopathy,PCV)的分类标准,并提出PCV的系统分类法。方法:42例(48只眼)国人PCV患者根据PCV的眼底表现和吲哚青绿血管造影(indocyaninegreenangiography,ICGA)特征,按息肉状病灶发生的部位、息肉状病灶渗漏程度、有无与息肉状病灶相连的分支状脉络膜血管网及眼底出血、渗出的严重程度进行分类。结果:48只PCV患眼按息肉状病灶发生的部位分为黄斑型(30只眼,占62.5%)、血管弓型(6只眼,占12.5%)、视乳头旁型(3只眼,占6.3%)、中周型及结合型(9只眼,占18.8%);按息肉状病灶渗漏程度分为活动性(34只眼,占73.8%)与非活动性(14只眼,占29.2%);按有无与息肉状病灶相连的分支状脉络膜血管网分为典型(36只眼,75.0%)与非典型(12只眼,25.0%);按眼底出血、渗出的严重程度分为渗出型(13只眼,占27.1%)与出血型(35只眼,占72.9%)。其中按息肉状病灶发生的部位和按有无与息肉状病灶相连的分支状脉络膜血管网进行分类为本研究首次提出。结论:PCV的上述分类有助于PCV的诊断与鉴别诊断、指导治疗及判断预后。 相似文献
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息肉状脉络膜血管病变(PCV)以往被称为特发性息肉状脉络膜血管病变(IPCV),是一种慢性脉络膜血管异常性疾病,由于脉络膜血管的渗出和出血导致多发性、反复性和出血性色素上皮层脱离。PCV包括出血型和渗出型两种类型,其中出血型容易并发黄斑下出血(SMH)。近年来随着吲哚菁绿血管造影(ICGA)和光学相关断层扫描血流成像(OCTA)在眼科学广泛应用,国内和国外对该病的研究逐渐深入。目前对该疾病的诊断主要是通过散瞳眼底检查、光学相干断层扫描(OCT)、OCTA、荧光素血管造影(FFA)+ICGA等辅助检查确诊。当并发少量的SMH可自行吸收,当SMH较大时很难自行吸收且对视力影响较大,主要的治疗方法包括抗VEGF药物、PDT、气体、t-PA以及联合玻璃体切除术等。本文结合国内外研究的最新进展,对PCV并发SMH的流行病学、发病机制、诊断、治疗等进行综述,并对其治疗方法进行讨论和展望。 相似文献
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脉络膜组织结构及功能的完整对视网膜功能正常发挥起重要作用.息肉状脉络膜血管病变(polypoid choroidal vasculopathy,PCV)是一类以异常分支状血管网和血管网末端息肉状膨大为特征的视网膜脉络膜疾病.其属于肥厚型脉络膜疾病谱,谱系疾病之间可以发生转化并且存在特征性脉络膜改变:局灶性或弥漫性脉络膜... 相似文献
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息肉样脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)表现为眼底后极部脉络膜异常分支血管网末端局限性膨隆,呈息肉状改变,伴复发性出血,并有浆液性或出血性色素上皮脱离.自发现以来,吲哚青绿血管造影(indocyanine green angiography,ICGA)被认为是诊断PCV的金标准.随着相干光断层扫描(optical coherence tomography,OCT)成像技术的不断发展,从时域-OCT中特征性的“双层征”到在谱域-OCT中可清晰呈现的异常血管网和息肉状改变,再到穿透性更强的OCT血管造影技术中扩张的脉络膜血管和息肉状结构反射信号的改变,逐步为PCV的非侵入性诊断提供更多可靠依据. 相似文献
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目的:观察光学相干断层扫描血管成像(OCTA)与吲哚青绿血管造影(ICGA)在息肉样脉络膜血管病变(PCV)中的图像特征.方法:选取2016-01/12在我院治疗的PCV患者21例21眼,所有患眼均行ICGA检查,检查完后1h行OCTA检查.观察OCTA和ICGA图像特征情况.结果:ICGA检查可见8眼有脉络膜异常分支血管网(BVN),息肉样病变10眼,BVN合并息肉样病变2眼,无明显异常表现1眼;ICGA检查表现为BVN者8眼,在OCTA检查中均可见病变位置、范围及形态与ICGA相似的BVN表现;ICGA检查表现为息肉样病变者10眼,OCTA检查均表现为强信号亮点;ICGA检查表现为BVN合并息肉样病变者2眼,OCTA检查均可见BVN和对应部位的强信号亮点;ICGA检查无明显异常表现者1眼,在OCTA检查中同样无异常表现.结论:PCV病变位置和形态在OCTA和ICGA中具有相似性,在ICGA检查受限的PCV中,OCTA或许在诊断中能发挥一定作用. 相似文献
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Polypoidal choroidal vasculopathy 总被引:10,自引:0,他引:10
Polypoidal choroidal vasculopathy was first described as a peculiar hemorrhagic disorder of the macula, characterized by recurrent sub-retinal and sub-retinal pigment epithelium bleeding in middle aged black women. The use of indocyanine green angiography and subsequently of optical coherent tomography has widened our ability to study and understand the pathophysiology of this disorder. The primary abnormality involves the choroidal circulation, and the characteristic lesion is an inner choroidal vascular network of vessels ending in an aneurysmal bulge or outward projection, visible clinically as a reddish orange, spheroid, polyp-like structure. We have also recognized that individuals of African-American and Asian descents are more at risk for developing polypoidal choroidal vasculopathy as the disorder seems to preferentially affect pigmented individuals. However, it has been shown that while that still holds true, patients of other racial backgrounds may be afflicted. Particularly, polypoidal choroidal vasculopathy has been found to be present in about 8-13% of white patients with clinical appearance of exudative age-related macular degeneration. Polypoidal choroidal vasculopathy has also been reported in Irish, French, German, and Italian patients. The natural course of the disease often follows a remitting-relapsing course, and clinically, it is associated with chronic, multiple, recurrent serosanguineous detachments of the retinal pigment epithelium and neurosensory retina with long-term preservation of good vision. Photodynamic treatment appears to be a promising alternative to conventional laser therapy, for the treatment of polypoidal choroidal vasculopathy. In conclusion, polypoidal choroidal vasculopathy seems to be a distinct clinical entity that should be differentiated from other types of choroidal neovascularization associated with age-related macular degeneration and other known choroidal degenerative, inflammatory, and ischemic disorders. 相似文献
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Iwama D Tsujikawa A Sasahara M Hirami Y Tamura H Yoshimura N 《Japanese journal of ophthalmology》2008,52(2):116-121
Purpose To study the prevalence and clinical features of drusen in eyes with polypoidal choroidal vasculopathy (PCV).
Methods Retrospectively, we reviewed the records of 98 consecutive patients with PCV (102 eyes). Drusen were examined in the inner
macula, which was defined as an area within 1500μm of the center of the fovea. Eyes that had at least one intermediate or
large (≥63μm) soft druse within the inner macula were defined as having drusen.
Results In these 102 eyes with PCV, 23 (23%) showed soft drusen in the inner macula. In such cases, the fellow eyes, those without
a PCV lesion, sometimes also showed soft drusen in the inner macula (11 eyes); 34 (33%) of the eyes with PCV had soft drusen
in the inner macula of at least one eye. Comparison of the group of eyes with PCV and drusen in one or both eyes with the
group with PCV and no drusen in either eye revealed no significant difference in patient characteristics or in ocular manifestations.
Conclusions Drusen are not an unusual feature of PCV, at least in Japanese patients, and, when present, they appear to have only a minor
effect, if any, on the clinical course. 相似文献