年龄相关性脉络膜萎缩18例临床分析

目的：报告年龄相关性脉络膜萎缩的临床特点。方法：应用谱域光学相干断层扫描仪测量脉络膜厚度,扫描设置为5°×15°矩形,范围包括黄斑和乳头旁视网膜。以脉络膜厚度〈125μm为选入标准,但应排除高度近视、葡萄膜炎史、外伤史、光动力疗法治疗史、玻璃体腔内类固醇注射史。对患者进行视力、黄斑外观及结构的检查,并对该病与青光眼间的相关性进行研究。结果：共选入患者18例28眼,平均年龄为78.6岁。所有的眼底均有豹纹状外观,平均中心凹下脉络膜厚度66.8μm。有12例18眼没有年龄相关性黄斑变性,平均视力0.5,黄斑区有色素改变,类似早期老年性黄斑变性。另外10眼同时并发老年性黄斑变性。有6例患者同时患有青光眼,盘周均有萎缩弧。结论：年龄相关性脉络膜萎缩主要发生于老年人,其后极病变类似于或同时伴有典型的年龄相关性黄斑变性改变。患有年龄相关性脉络膜萎缩具有发生青光眼的高风险性。

Clinical analysis of age-related choroidal atrophy in 18 cases

AIM:To report the clinical characteristics of age-related choroidal atrophy. METHODS: The choroidal thickness was measured by spectral-domain optical coherence tomography. The scans were obtained within a 5°×15° rectangle to encompass the macula and temporal juxtapapillary retina. The choroidal thickness of patients less than 125μm in thickness were included, whereas eyes with myopia of 6 diopters or more, a history of uveitis, trauma,photodynamic therapy, and intravitreal corticosteroid injection were excluded. The patients were evaluated for visual acuity, macular appearance,and the presence of glaucoma. RESULTS: There were 18 cases (28 eyes) with a mean age 78.6 years. All eyes had a tessellated fundus appearance. The mean subfoveal choroidal thickness was 66.8μm. Of the 12 caces (18 eyes) that had no evidence of late age-related macular degeneration(AMD), the mean visual acuity was 0.5, there were pigmentary changes in the macula mimicking early AMD.Concurrent late AMD was found in the 10 remaining eyes. Glaucoma was present in 6 patients, all of whom had peripapillary atrophy. CONCLUSION: Age-related choroidal atrophy affects older individuals in whom posterior pole abnormalities develop that may mimic and also be associated with findings typical for AMD. Patients with age-related choroidal atrophy may be at higher risk for glaucoma.