息肉状脉络膜血管病变的现状和进展

息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)是一种发病原因和发病机制不明的疾病,一些研究表明其可能与某些基因有关。PCV眼底镜下表现常与渗出型年龄相关性黄斑变性(age-related macular degeneration,AMD)相似,通过吲哚青绿血管造影(indocyanine green angiography,ICGA)及光学相干断层扫描(optic coherence tomography,OCT)等影像学检查可予以鉴别。目前主要通过眼底镜下特征性的橘红色息肉状损害和ICGA下见血管网边缘息肉状血管损害对PCV进行诊断。主要的治疗方法包括光动力疗法(photodynamic therapy,PDT)、抗血管生成药物及联合疗法等。我们从历史、流行病学、病理学、发病机制、基因、临床表现、影像学、诊断及治疗等方面对其进行综述,并提出了对PCV的研究方向的讨论和展望。

Status and progress of polypoidal choroidal vasculopathy

Polypoidal choroidal vasculopathy(PCV)is a disease of which the etiology and pathogenesis are still unknown, and some studies have shown that it may be related to certain genes. The funduscopic presentation of PCV is similar to that of exudative age-related macular degeneration(AMD). PCV could be distinguished from AMD through imaging such as indocyanine green angiography(ICGA)and optic coherence tomography(OCT). The diagnosis could be made if subretinal orangered lesions by ophthalmoscope and branching choroidal vessels with poly-like terminal aneurismal dilations on ICGA are seen. The treatment of PCV mainly includes photodynamic therapy(PDT), intravitreal anti-angiogenesis therapy, and combination therapy. We review the nature of PCV through its history, epidemiology, pathology, pathogenesis, gene, clinical manifestation, imaging, diagnosis and treatment. The further research direction of PCV is discussed and proposed at last.