息肉状脉络膜血管病变的分类研究

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。

The Study of the Classification on Polypoidal Choroidal Vasculopathy

Purpose: To establish and explore the criteria of the classification on polypoidal choroidal vasculopathy(PCV). Methods: The 42 patients (48 eyes) with PCV were classified according to the location, staining or not in late indocyanine green angiography (ICGA), with or without branching vascular network, and the extent of hemorrhagic or exudative. Results: According to the location, staining or not in late ICGA, with or without branching vascular network, and the extent of hemorrhagic or exudative, the PCV were classified as macular (30 eyes, 62.5%), arcade (6 eyes, 12.5%), peripapillary (3 eyes, 6.3%), midperiphery and Combination PCV (9 eyes, 18.8%); active (34 eyes, 70.8%) and inactive PCV (14 eyes, 19.2%); typical (36 eyes, 75.0%) and atypical PCV (12 eyes, 25.0%); hemorrhagic (35 eyes, 72.9%) and exudative PCV (13 eyes, 27.1%), respectively. The classification on location of the polypoidal lesions and with or without branching vascular network of the lesions were the first suggested. Conclusions: The classification of PCV is beneficial for describing the clinical manifestations and for predicting the prognosis and for guiding the treatment of the disease.