脉络膜黑色素瘤的病理特点与预后

目的　分析脉络膜黑色素瘤的病理特点及预后影响因素。方法　对天津市眼科医院2003年10月至2014年3月入院的31例（31眼）经病理证实的脉络膜黑色素瘤进行回顾性研究，总结病理特点及预后影响因素。结果　脉络膜黑色素瘤31例（31眼）中男18例（58.1%），女13例（41.9%）；均为单眼发病，右眼17例（54.8%），左眼14例（45.2%）；年龄30~71岁，平均52.5岁。肿瘤位于睫状体者7眼，位于赤道后者15眼，位于旁视神经者4眼，位于赤道前者5眼。瘤体呈蘑菇状者6眼，呈圆顶状者5眼，呈类圆形者3眼，呈半圆形者4眼，呈扁平形者12眼，呈弥漫状者1眼。31眼中，大肿瘤8眼，中等肿瘤23眼。肿瘤细胞类型:梭形细胞型7眼（眼内期4眼，青光眼期1眼，眼外蔓延期2眼），上皮细胞型4眼（眼内期3眼，眼外蔓延期1眼），混合细胞型20眼（眼内期15眼，青光眼期2眼，眼外蔓延期2眼，全身转移期1眼）。肿瘤细胞向巩膜外蔓延程度:Ⅰ级15眼，Ⅱ级6眼，Ⅲ级3眼，Ⅳ级7眼。在Ⅳ级中有4眼伴有大量坏死，大部分为大肿瘤。眶内蔓延途径:沿巩膜导管和巩膜涡静脉蔓延者6眼；直接侵犯巩膜、向眼球外蔓延者5眼；沿筛板直接蔓延者1眼；侵犯视网膜、睫状体、虹膜、结膜者4眼。随访22例患者中有2例死亡，均为混合细胞型并发肝转移，存活时间为术后17个月（全身转移期）和28个月（眼内期）。结论　脉络膜黑色素瘤的预后受多种因素的影响（位置、形状和体积、瘤细胞类型、扩散途径等），沿巩膜导管、巩膜涡静脉蔓延和侵犯巩膜、向眼球外蔓延是主要的蔓延途径。     

特发性黄斑裂孔的临床观察

目的 观察特发性黄斑裂孔的临床特点和视力。 方法 回顾性分析特发性黄斑裂孔病例18例23只眼的临床表现；按Gass的标准分期；随访6-120。 结果 初诊时黄斑裂孔Ⅰ～Ⅳ期依次为5，4，10，3只眼，随访期间发生黄斑裂孔1只眼。随访末次时，黄斑裂孔Ⅰ～Ⅳ期依次为2，2，9，8只眼，自愈2只眼。主诉患病时间Ⅰ期5～8个月，Ⅱ期8～20个月，Ⅲ期12～126个月。初诊时，平均视力Ⅰ期0.7,Ⅱ期0.55，Ⅲ期0.08，Ⅳ期0.08。初诊时FFA：Ⅰ期无明显异常，Ⅱ～Ⅳ期黄斑部透见脉络膜荧光17只眼。 结论 特发性黄斑裂孔患者随着病程延长，前期黄斑裂孔多发展成全层裂孔，全层裂孔扩大，视力减退。 (中华眼底病杂志,1998,14:222-223)     

视网膜母细胞瘤患者全身化学药物治疗联合眼部治疗的临床疗效观察

目的：观察视网膜母细胞瘤（RB）患者全身化学药物治疗（化疗） 联合眼部治疗的 临床效果。 方法：回顾分析37例56只眼行全身化疗联合眼部治疗的RB患 者的生存率、眼球保留 率以及病情得到良好控制的情况。病情得到良好控制的标准为：（1）眼部肿瘤缩小乃至消 失，肿瘤病灶呈软乳酪样改变或出现钙化和瘢痕化；（2）眼球摘除者未出现眼眶肿瘤复发 ；（3）临床检查未见肿瘤转移。所有患者均至少有一只肿瘤眼分期为Ⅲb期或以上并接受化 疗。根据肿瘤对化疗的反应情况，一般接受6轮全身化疗，每轮化疗间隔3~4周。化疗药物组 成为：长春新碱、环磷酰胺、依托泊甙(VP16)、卡铂。另外,根据情况分别联合激光光凝、 冷冻、经瞳孔温热疗法（TTT）、钌¹⁰⁶放射敷贴器局部放射治疗以及眼球摘除等眼部 治疗。 治疗和观察时间2~59个月，平均观察时间为35个月。 结果：除1例双眼发 病患者眼球摘除手术 后失访外，观察期内30例患者存活，占83.3%；6例患者死亡，占16.6%。30例存活患者的45 只肿瘤眼中，肿瘤分期为I-Ⅱ期(早期)、Ⅲ-Ⅳ期(中期)和Ⅴ期(晚期)者眼球保存率分 别为100%（10只眼）、7 0.0%（10只眼）和14.3%（21只眼），随访期内病情均得到良好控制。6例死亡患者均为肿瘤 分期Ⅳ期 以上，最终死于肿瘤脑转移。 结论：全身化疗联合多种眼部治疗可以有效地治疗RB。     

息肉状脉络膜血管病变的眼底血管造影表现

目的 观察息肉状脉络膜血管病变(PCV )的临床特征及眼底血管造影表现。 方法 回顾分析12例PCV患者12只眼的眼底检查、荧光素眼底血管造影(FFA)、吲哚青绿血管造影(ICGA)及其5例5只眼的光相干断层扫描(OCT)检查资料。 结果 12只眼均可见深层和(或)浅层出血，黄色脂质渗出。其中6只眼病变处见橘红色病灶，2只眼伴视网膜前出血。FFA检查，静脉期6只眼橘红色病灶内点状荧光，4只眼病变处可见脉络膜血管网。晚期均见息肉状强荧光点荧光素渗漏，2只视网膜前出血眼晚期未见荧光素渗漏。ICGA检查，12只眼晚期见强度不等、簇状或孤立的息肉状扩张灶，4只眼显示明显的脉络膜血管网。OCT检查，4只眼视网膜色素上皮（RPE）和脉络膜毛细血管高反射层呈穹窿状隆起，1只眼无改变。 结论 PCV眼底多见黄斑区出血性和(或)浆液性视网膜色素上皮脱离(RPED)和(或)神经上皮脱离，黄色脂质渗出。FFA及ICGA检查可见分支状脉络膜血管网及末梢膨大息肉状扩张灶。 （中华眼底病杂志，2004，20：310-312）     

不同病变时期Best卵黄样黄斑营养不良的光相干断层扫描图像特征

[目的]观察不同病变时期Best卵黄样黄斑营养不良(BVMD)的光相干断层扫描(OCT)图像特征.[方法]临床确诊为BVMD的28例患者56只眼纳入研究.所有患者常规行最佳矫正视力、裂隙灯显微镜、直接检眼镜、前置镜、眼底照相、眼电图、荧光素眼底血管造影检查.56只眼中,0期8只眼,Ⅰ期2只眼,Ⅱ期10只眼,Ⅱa期12只眼,Ⅲ期6只眼,Ⅳa期6只眼,Ⅳb期5只眼,Ⅳc期7只眼.患者同时行OCT检查,观察不同病变时期的OCT图像特征.[结果]OCT检查发现,0期患眼黄斑区未见明显异常.Ⅰ期患眼黄斑区结构正常,视网膜色素上皮(RPE)下小团块强反射病灶,可见浆液性视网膜脱离.Ⅱ、Ⅱa期患眼RPE-脉络膜毛细血管复合体(ORCC)呈弥漫性增厚隆起信号增强,黄色物质位于光感受器细胞内外节连接( IS/OS)与RPE层之间;Ⅱa期患眼RPE-ORCC增厚区域小,呈圆锥样隆起有弱反射区围绕.Ⅲ期患眼病灶上半部分表现为弱反射区,下半部分黄色物质表现为强反射并堆积于IS/OS与RPE层之间.Ⅳa期患眼病灶处神经感觉层下为无反射区,边界清晰,其下RPE-ORCC变薄,IS/OS光带及外界膜缺失.Ⅳb期患眼纤维化病灶RPE层增厚、隆起,呈强反射,视网膜神经上皮变薄和其上方广泛的IS/OS光带缺失.Ⅳc期患眼RPE连续性中断,可伴有黄斑部水肿.[结论]BVMD病灶中的黄色物质位于IS/OS与RPE层间,表现为强反射.Ⅱa期～Ⅳ期BVMD患眼的OCT典型图像特征为外核层与RPE层之间大小不一的腔隙样弱反射区伴或不伴有同一区间锥形强反射灶.     

Vogt-小柳-原田综合征葡萄膜炎期荧光素钠及吲哚菁绿同步眼底血管造影特征分析

目的探讨Vogt-小柳-原田综合征(Vogt-Koyanagi-Harada disease,VKH)葡萄膜炎期荧光素钠及吲哚菁绿同步眼底血管造影的影像学特征及其临床意义,为诊断及病程监测提供依据。方法回顾性分析11例22眼VKH葡萄膜炎期患者应用海德堡HRA2共焦激光扫描眼底血管造影系统进行的荧光素钠眼底血管造影(fundus fluorescein angiography,FFA)和吲哚菁绿血管造影(indocyanine green angiography,ICGA)同步检查资料,比较2种检查的影像学特征。结果 11例22眼中,FFA检查8眼(36.36%)后极部多处脉络膜充盈迟缓;9眼(40.91%)视盘渗漏水肿;22眼(100.00%)后极部视网膜色素上皮密集针尖状高荧光渗漏,18眼(81.82%)后极部神经上皮脱离部位FFA晚期形成多囊样或多湖状荧光积存;13眼(59.09%)静脉期散在、均匀脉络膜炎性病灶,呈斑点状低荧光。ICGA检查15眼(68.18%)脉络膜充盈迟缓;14眼(63.64%)脉络膜血管扩张;16眼(72.73%)播散状分布、斑点状脉络膜炎性低荧光病灶;18眼(81.82%)后极部神经上皮脱离区大多呈现持续低荧光,晚期部分囊样病灶呈中强荧光;9眼(40.91%)视盘水肿晚期显示视盘及盘周低荧光。FFA和ICGA同步检查结果:FFA检查100.00%患眼静脉期视盘周及后极部密集点状高荧光渗漏,而在ICGA上无此征象;FFA检查视盘表面毛细血管扩张比ICGA显示更明显;ICGA检查脉络膜充盈迟缓15眼(68.18%)及斑点状炎性病灶16眼(72.73%),均高于FFA检查结果的8眼(36.36%)和13眼(59.09%),而且ICGA早期脉络膜血管扩张显示更清晰;后极部神经上皮脱离病灶在FFA静脉期表现为低荧光,晚期形成荧光积存,而病变区域ICGA检查相应部位多为持续低荧光。结论 VKH葡萄膜炎期FFA清晰显示视网膜色素上皮损伤特征以及炎症累及视盘、视网膜的程度和范围;ICGA能够清晰显示脉络膜循环改变及脉络膜炎症的活动性和范围。FFA和ICGA同步检查对VKH诊断及发病机制有重要的指导意义。     

297例视网膜母细胞瘤的临床病理研究

目的 探讨视网膜母细胞瘤脉络膜浸润的形态学分期标准,为在统一的上进一步对该肿瘤进行临床病理研究。方法 对摘除的２９７例原发性Ｒｂ患者的眼球组织标本,进行光镜观察。结果 肿瘤侵犯球壁组织在形态学上可分为４期（色素上皮－脉络膜分期）Ⅰ期,仅 色素上皮层受侵犯,Ｂｒｕｃｈ膜结构完整,Ⅱ期,Ｂｒｕｃｈ膜结构被各膜毛细血管层未被侵犯,Ⅲ期,肿瘤浸润深达脉络膜,靠近毛细血管层的中血管层内的小范围区域,Ⅳ期,大     

视网膜母细胞瘤细胞分化程度对扩散和 存活预后的影响

目的探讨视网膜母细胞瘤（retinoblastoma,RB）细胞分化程度对扩散和存活预后的影响。方法对156份RB眼球标本 进行组织病理学观察，根据肿瘤细胞分化程度将其分为分化型与未分化型，注意有无肿瘤细 胞的扩散，并统计两型发生扩散的比率。对随访到的82例RB患者进行死亡率统计。用检验的方法比较两型间死亡率和扩散发生率。记录扩散部位与死亡率之间的关系、死者生前眼球摘除术后平均存活时间。结果分化型RB　17例17只眼，发生肿瘤细胞局部扩散8只眼，占47.06%；未分化型137例139 只眼，发生局部扩散66只眼，占47.48%。两型间发生扩散的比率差异无显著性意义（P>0.05）。随访到的患者中，分化型RB死亡率27.27%，未分化型RB死亡率22.54%，二者比较差异亦无显著性意义（P>0.05）。眶内和巩膜侵犯者死亡率100%，视神经侵犯Ⅳ级者死亡率62.50%，葡萄膜侵犯者死亡率22.22% 。眼球摘除术后生存时间为5～41个月，平均21.92个月。结论分化型与未分化型RB的存活预后及局部扩散比率差异无显著性意义。发生扩散的RB，无论是分化型还是未分化型其预后均取决于扩散的程度以及是否进行积极治疗。(中华眼底病杂志,2001,17:18-20)     

年龄相关性黄斑变性发病机制研究热点：血管模式[英]／Friedman E…／／Br J Ophthalmol.

年龄相关性黄斑变性(AMD)血管模式的确立，基于AMD与动脉粥样硬化有共同的风险因素和发病机制。该模式认为AMD是视网膜色素上皮(RPE)、脉络膜灌注损坏的血管病变。其发病机制为：(1)由于脂质进行性浸润，眼组织顺应性降低，脉络膜血管阻力增加。随年龄增长，黄斑区脉络膜毛细血管进行性变窄，亦促使阻力增强。     

不同病变阶段视网膜色素变性患者脉络膜血管状态的荧光血管造影特征

目的:探讨不同病变阶段视网膜色素变性患者的脉络膜血管状态.方法:回顾性分析云南省第二人民医院眼科2000年1月至2015年4月诊断为原发性视网膜色素变性的患者226例(452眼)的眼底特征,并复习相关文献,重点分析总结脉络膜血管情况.结果:31例(62眼)病变前期患者,荧光素眼底血管造影显示动脉期脉络膜血管及视网膜血管充盈正常,未出现充盈延迟或缺损现象.25例(50眼)病变早期患者,荧光素眼底血管造影显示动脉前期可见脉络膜背景荧光显示,部分脉络膜毛细血管未同时充盈,动脉期时上述部分完成充盈.106例(112眼)病变中期患者,荧光素眼底血管造影显示动脉期出现部分脉络膜毛细血管萎缩区,仅能看到残存的粗大脉络膜血管,随造影过程的进展,此区域并未出现充盈,即呈现永久的脉络膜毛细血管充盈缺损.64例(128眼)病变晚期患者荧光素眼底血管造影显示,广泛的脉络膜毛细血管萎缩区,其间可见残存的脉络膜粗大血管,至造影晚期均呈现充盈缺损,萎缩区边缘随造影过程呈强荧光表现.结论:荧光素眼底血管造影可显示脉络膜血管萎缩变化情况,这一指标可作为反映不同病变阶段视网膜色素变性患者病情进展变化的重要依据.     

Review of optical coherence tomography for intraocular tumors

PURPOSE OF REVIEW: Optical coherence tomography has assumed an important role in the management of numerous ocular conditions. With regard to ocular oncology, optical coherence tomography can illustrate retinal changes overlying choroidal tumors. Some of these features include photoreceptor loss, intraretinal edema, and retinal thinning overlying choroidal nevus; fresh subretinal fluid with preservation of photoreceptors overlying choroidal melanoma; and intraretinal edema, retinoschisis, and retinal thinning overlying irradiated choroidal melanoma. RECENT FINDINGS: The optical coherence tomography features of tumors of the retinal pigment epithelium include typical findings of peaked vitreoretinal traction and retinal disorganization with combined hamartoma of the retina and retinal pigment epithelium, full-thickness retinal shadowing with congenital simple hamartoma, and photoreceptor loss and retinal thinning overlying congenital hypertrophy of the retinal pigment epithelium. SUMMARY: Optical coherence tomography of retinal tumors, such as retinoblastoma and astrocytic hamartoma, reveals full-thickness replacement of the retinal anatomic layers with the tumor and shadowing corresponding to the intralesional calcification. For all intraocular tumors, optical coherence tomography provides valuable information regarding the status of the retina and the retinal pigment epithelium and can be useful in ascertaining reasons for visual loss.     

Acute sectorial choroidal ischemia

Four eyes (of three patients) with sectorial choroidal ischemia by temporal arteritis or carotid obstruction underwent fluorescein angiography during and after the acute phase. In all cases hypoperfusion affected the whole temporal choroid; however, disturbance of retinal pigment epithelium was much less extensive. In two cases the retinal pigment epithelium became necrotic and scarred within a limited area that was typically triangular in shape; in the third case scarring was limited to some pigmented streaks, and in the fourth case, retinal pigment epithelium remained normal. The triangular scar that appeared after episodes of choroidal hypoperfusion did not seem to be a true reflection of the extent of the choroidal artery obstruction in the acute phase. Our observations suggest that the deficient choroidal perfusion involved more than the choroidal artery supplying the triangular area of pigment epithelium disturbance. Several mechanisms (for example, retrograde venous filling, restoration of perfusion) reduce the deleterious effects of ischemia. Thus the necrosis of the retinal pigment epithelium would appear in only those sectors where ischemia was particularly severe or prolonged.     

Combined hamartoma of the retina and retinal pigment epithelium with full thickness retinal hole and without retinoschisis

Combined hamartoma of the retina and retinal pigment epithelium has been described as a rare, benign tumor formed by an overgrowth of several constituents of the retina such as the retinal pigment epithelial cells, vascular elements, and glial components.1 Despite its varied clinical appearance it is important to recognize this tumor as it is known to simulate intraocular malignancies like retinoblastoma and choroidal melanoma.     

Choroidal invasion of retinoblastoma: metastatic potential and clinical risk factors.

There is considerable debate about the significance of choroidal invasion of retinoblastoma with regard to metastatic disease. The charts of patients with retinoblastoma were reviewed over a 17 year period to determine the frequency of histopathological choroidal invasion of retinoblastoma and its risk for eventual metastatic disease. Sixty seven of 289 eyes (23%) enucleated for retinoblastoma had histopathological evidence of choroidal invasion. Those patients with choroidal invasion (with or without optic nerve invasion) were more likely to develop metastases than those without choroidal invasion (p = 0.0001). When considering those patients with isolated choroidal invasion of retinoblastoma, excluding those with associated optic nerve invasion, there was no significant risk but there was a trend towards the development of metastases (p = 0.10). The clinical factors found to be predictive for choroidal invasion from retinoblastoma from a univariate analysis included increased intraocular pressure (p = 0.04) and iris neovascularisation (p = 0.007) and, from a multivariate analysis, iris neovascularisation (p = 0.02). The histopathological factors statistically associated with choroidal invasion included the presence of optic nerve invasion (p = 0.002) and poorly differentiated retinoblastoma (p = 0.003). Factors not predictive for choroidal invasion included the age, race, and sex of the patient and the tumour laterality, inheritance, size, and growth pattern. Choroidal invasion of retinoblastoma is a risk for metastases, especially if it is associated with any degree of optic nerve invasion.     

Adenoma of the retinal pigment epithelium simulating a juxtapapillary choroidal neovascular membrane

We report a case of an adenoma of the retinal pigment epithelium that clinically simulated a juxtapapillary choroidal neovascular membrane in a 60-year-old man. Fluorescein angiography supported the diagnosis of a juxtapapillary choroidal neovascular membrane in his left eye. After 13 years the lesion become slightly pigmented and the optic disc became swollen. The possibility of choroidal melanoma with optic disc invasion was considered, and the eye was enucleated. The lesion proved histopathologically to be an adenoma of the retinal pigment epithelium.     

Retinal pigment epithelial tear after transpupillary thermotherapy for choroidal neovascularization

PURPOSE: To describe two patients who developed a retinal pigment epithelial tear after transpupillary thermotherapy for choroidal neovascularization. METHOD: Case reports. RESULTS: Retinal pigment epithelial (retinal pigment epithelium) tear developed in 2 (8%) of 25 eyes after transpupillary thermotherapy for occult choroidal neovascularization associated with age-related macular degeneration. In both eyes, the retinal pigment epithelium tear developed between the treatment session and first post-treatment examination. In both eyes, the visual acuity was unchanged, but the complication of retinal pigment epithelium tear may result in decreased visual acuity when transpupillary thermotherapy is performed in an eye with good initial visual acuity. CONCLUSION: Retinal pigment epithelium tear appears to occur more frequently after transpupillary thermotherapy for poorly defined choroidal neovascularization than after conventional laser photocoagulation for poorly defined choroidal neovascularization.     

Simultaneous indocyanine green and fluorescein angiography in retinal pigment epithelium tear using the confocal scanning laser ophthalmoscope.

PURPOSE: To describe the indocyanine green angiographic pattern of retinal pigment epithelium tears in the setting of age-related macular degeneration compared with the fluorescein angiographic features. METHODS: Twelve consecutive patients (12 eyes) with a retinal pigment epithelium tear underwent simultaneous indocyanine green angiography and fluorescein angiography with the confocal scanning laser ophthalmoscope. The findings for the two modes were compared. RESULTS: Choroidal neovascular membrane was evident beneath the rolled retinal pigment epithelium on indocyanine green angiograms in 11(92%) of 12 eyes: a focal neovascular membrane was apparent in five (42%) of 12 eyes, whereas a plaque neovascular membrane was seen in six (50%) of 12 eyes. In comparison, fluorescein angiography demonstrated late leakage as a result of occult choroidal neovascular membrane in nine (82%) of 11 eyes but no well-defined choroidal neovascular membrane. CONCLUSIONS: Indocyanine green angiography is superior to fluorescein angiography for imaging choroidal neovascularization in cases of retinal pigment epithelium tear and may serve as an important adjunct to indocyanine green-guided laser treatment in selected cases.     

Prevalence and mechanisms of secondary intraocular pressure elevation in eyes with intraocular tumors

A survey of 2704 eyes with intraocular tumors in patients who were evaluated on the Oncology Service at Wills Eye Hospital showed that 126 of the tumor-containing eyes (5%) had tumor-induced elevated intraocular pressure (IOP) at the time of diagnosis of the tumor. Of the 2111 eyes with uveal melanomas, secondary IOP elevation was present in 55 (3%). Secondary IOP elevation was present in 7% of eyes with iris melanoma, 17% with ciliary body melanoma, and 2% with choroidal melanoma. The most common mechanism of elevated IOP was tumor invasion of the angle in the case of iris melanomas, pigment dispersion and tumor invasion of the angle in the case of ciliary body melanomas, and iris neovascularization in the case of choroidal melanomas. Of the 256 eyes with uveal metastases, secondary IOP elevation was found in 12 eyes (5%). Secondary IOP elevation was present in 64% of eyes with iris metastases, 67% with ciliary body metastases, and 1% with choroidal metastases. The most common mechanism of elevated IOP was tumor invasion of the angle in the case of iris and ciliary body metastases, and angle closure in the case of choroidal metastases. There were 303 eyes with retinoblastoma, 17% of which had elevated IOP which was secondary to iris neovascularization in 70% of cases and to an angle closure without neovascularization in 27%. Several other intraocular tumors including lymphoma, leukemia, medulloepithelioma, melanocytoma, and adenoma of the iris pigment epithelium were occasionally associated with secondary elevated IOP.     

MPPE的荧光素和吲哚青绿眼底血管造影的临床特征及意义

目的:观察多发性后极部色素上皮病变(multifocalposterior pigment epitheliopathy,MPPE)的荧光素眼底血管造影(fundus fluorescein angiography,FFA)和吲哚青绿眼底血管造影(indocyanine green angiography,ICGA)特征及其临床意义。方法:回顾性分析2007-01/2009-04期间在我院就诊的35例51眼MPPE患者的临床资料。所有患者都接受了常规视力、裂隙灯、直/间接眼底镜检查,同时行眼底彩色照相和德国海德堡共焦激光视网膜仪(HRA-2)的同步FFA和ICGA检查。结果:多灶性视网膜色素上皮(RPE)渗漏和脉络膜血管循环障碍(包括脉络膜血管充盈延迟以及脉络膜血管的扩张渗漏)是活动期MPPE患者在FFA和ICGA检查中的主要特征性改变。由于长期大量的RPE渗漏,部分患者会继发渗出性视网膜脱离,其中小部分在FFA检查中还有视网膜小血管普遍渗漏、视网膜无灌注区及新生血管形成、晚期视盘强荧光着色等慢性葡萄膜炎的改变。静止期MPPE患者在FFA和ICGA中的荧光改变则主要为RPE和脉络膜毛细血管的萎缩,而脉络膜血管充盈迟缓和血管扩张等循环异常变化基本消失。结论:MPPE有类似CSC的FFA和ICGA改变,但程度更重;其中部分患者还可伴有类似慢性葡萄膜炎的改变。MPPE的ICGA后期像中的暗黑色低红外荧光灶有助于我们判断患者病情的预后。