目的 观察息肉状脉络膜血管病变(PCV)的眼底表现及荧光素眼底血管造影(FFA)、吲哚青绿血管造影(ICGA)与相干光断层扫描(OCT)特征.方法 分析经眼底检查、FFA、ICGA及OCT确诊的PCV患者16例(16只眼)的眼底图像资料.其中OCT检查资料为8例(8只眼).结果 16例(16只眼)全部为单眼发病,其中男性10例,占62.5%,女性6例,占37.5%.年龄36～75岁,平均年龄63.4岁.眼底检查14只眼病变部位位于黄斑区,占87.5%,2只眼病变位于视盘颞侧,占12.5%.在黄斑区4只眼见橘红色结节样隆起病灶,13只眼视网膜下有出血,11只眼见脂质沉着.FFA检查16只眼早期均呈强荧光,后期进行性渗漏.其中6只眼表现血液性视网膜色素上皮脱离(PED),1只眼为浆液性PED,2只眼为血液性合并浆液性PED,1只眼呈脉络膜血管网及息肉样结构.ICGA检查16只眼均可见强度不等、簇状或孤立的息肉状扩张灶,其中12只眼可见伞样或树枝样异常扩张的脉络膜血管网.OCT检查8只眼显示7只眼视网膜色素上皮(RPE)和脉络膜毛细血管高反射层呈穹隆状隆起,其下可见结节状改变.1只眼无脉络膜毛细血管高反射层改变.6只眼表现血液性PED,2只眼为浆液性PED合并神经上皮脱离.结论 PCV单眼发病为主,好发部位为黄斑区,最常见表现为视网膜下出血及脂性渗出,部分患眼存在PED.大部分患眼ICGA可见特征性的脉络膜血管网及其末梢的息肉状扩张灶.%Objective To investigate the clinical features of polypoidal choroidal vasculopathy ( PCV Jin Chinese patients. Methods Fundus examination,fundus fluorescein angiographyl FFA ),and indocyanine green angiography ( IC-GA ) were performed on 16 patients( 16 eyes ) with PCV,out of whom 8 underwent optical coherenece tomography( OCT ). Results Sixteen patients affected eyes unilaterally. The patients included 10 males( 62. 5% )and 6 females ( 37. 5% ) aging from 36 to 75 year old ( average63. 4 ). The predominant location for these lesions was the macular region in 14 eyes ( 87. 5% ), peripapillary region in 2( 12. 5% ). In 16 eyes with PCV, 13( 81. 25% ) had subretinal hemorrhage, 11 ( 68. 75% )had yellow-white exudation,4( 25% ) had reddish-orange nodular elevations in the macular area. The results of FFA discovered hemorrhagic or( and )serous pigment epithelium detachment( PED ) in 9eyes and choroidal vascular network in 1 eyes. At the late phase, leakage of hyperfluorescence spot in all of the eyes were found. ICGA revealed polypoidal dilations with umbrellalike or twiglike branching vascular networks in 12 eyes and scattered polypoidal dilations without identifiable continuous branching vascular network in 4 eyes. OCT disclosed protrusion of the retinal pigment epitelium ( RPE ) with abumpy surface at polypoidal structure in 7 eyes and no change in 1 eye. An apparent discontinuity was observed in the highly reflective layer which delineates the polypoidal structure. Conclusion The eyes was affected mostly unilaterally in PCV. Most of polypoidal vascular lesions are present in the macular area, subretinal hemorrhage, serous PED, and ( or ) neuroepithelial detachment with yellow hard exudations are the main manifestations. Branching choroidal vascular net with ployplike terminal anourysmal dilations can be discovered in ICGA.
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