渗出型老年性黄斑变性视网膜脉络膜血管吻合与视网膜色素上皮脱离的关系分析

目的 探讨老年性黄斑变性（AMD）视网膜脉络膜血管吻合（RCA）与视网膜色素上皮脱离（PED）的关系。 方法 回顾分析2000年10月～2003年12月诊治的渗出型AMD患者70例75只眼的光相干断层扫描（OCT）和眼底血管造影检查资料，观察有无RCA形成以及与PED 发生的关系。 结果 75只渗出型AMD患眼中，34只眼有RCA形成，占45.3% ；41只眼未见RCA ，占54.7%。有RCA形成同时存在PED者30只，占88.2%；不伴有PED者4只眼，占11.8%。无RCA 形成但存在PED者33只眼，占80.5%；不伴有PED者8只眼，占19.5%。有无RCA形成的患眼PED的发生率比较，差异无显著性的意义（χ2=0.83，P=0.5290）。无RCA形成的33只PED患眼中，发生PED裂孔者17只眼，占51.5%；有RCA形成的30只PED患眼中，发生PED裂孔者26只眼，占8 6.7%，二者比较，差异有显著性的意义（χ2=8.9612，P=0.0030）。 结论 RCA形成在渗出 型AMD患眼中并不少见；RCA多与PED并存，但两者之间无直接的因果关系；PED裂孔发生与RCA形成密切相关。 （中华眼底病杂志，2004，20：295-298）

The correlation between retinal-choroidal anastomosis and pigment epithelium detachment secondary to exudative age-related macular degeneration

Objective To evaluate the correlation between retinal-choroidal anastomosis (RCA) and pigment epithelium detachment (PED) secondary to exudative age-related macular degeneration (AMD). Methods From October 2000 to December 2003,75 eyes of 70 patients with active exudative AMD underwent OCT, fluorecein and/or indocyanine green angiography (FA/ICGA) examinations were analyzed to ascertain whether there was RCA. The correlations between RCA and PED were evaluated. Results Of 75 eyes with exudative AMD, 34 eyes (45.3%) had RCA, 41 eyes (54.7%) had no RCA. Among the eyes with RCA, 30 eyes (88.2%) had PED, the remaining 4 eyes (11.8%) had no PED. Among the eyes without RCA, 33 eyes (80.5%) had PED, and 8 eyes (19.5%) had no PED. There was no significant difference in the incidence of PED between eyes with or without RCA (χ2=0.83, P=0.5290). PED tear was found in 17 eyes (51.5%)out of 33 eyes with PED and without RCA, but in 26 eyes (86.7% ) out of 30 eyes with both PED and RCA. There was a significant difference in the incidence of PED tear between eyes with or without RCA (χ2=8.9612, P=0.0030). Conclusions RCA is not uncommon in exudative AMD. It often coexisted with PED, but there is no direct correlation between them. PED tear is highly correlated with RCA formation. (Chin J Ocul Fundus Dis，2004，20：295-298)