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目的 观察渗出型老年性黄斑变性 (AMD)与息肉状脉络膜血管病变 (PCV)眼底表现的异同。 方法 回顾性分析渗出型 AMD患者 12 3例 137只眼及 PCV患者 4 2例 4 8只眼的眼底彩色像、荧光素眼底血管造影 (FFA)和吲哚青绿血管造影 (ICGA)检查资料。 结果 137只渗出型 AMD患眼中 ,FFA显示 16只眼为典型脉络膜新生血管 (CNV) ,占 11.7% ;隐匿型 CNV12 1只眼 ,占 88.3%。隐匿型 CNV患眼中 ,4 2只眼 ICGA检查可见“热点状”(hot spots)荧光 ,占 34.7% ;74只眼表现为后期斑状强荧光 ,占6 1.2 % ;2只眼 CNV与 PCV共存 ,占 1.7%。 4 8只 PCV眼中 ,7只眼的眼底彩色像可见特有的视网膜下橘红色结节样病灶 ,占 14 .6 % ;2只眼 FFA即显示出分支状脉络膜血管网及息肉状病灶 ,占 4 .2 % ;36只眼ICGA显示异常分支的脉络膜血管网及其末梢的息肉状扩张灶 ,占 75 .0 % ;12只眼 ICGA显示多个息肉状扩张灶而未见伴有分支状脉络膜血管网 ,占 2 5 .0 %。息肉状病灶呈葡萄串样外观者 16只眼 ,占 33.3% ;,呈多个孤立并存者 32只眼 ,占 6 6 .7%。造影后期部分息肉状病灶染料渗漏或染色 ,部分呈息肉状病灶中心为弱荧光 ,周围环状染色的“冲刷现象”。 结论 渗出型 AMD与 PCV不同的 ICGA表现及 PCV眼底特征性的视网膜下橘红色结节
Objective To observe the similarities and differences between the exudative age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV). Methods The fundus color images, fundus fluorescein fundus angiography (FFA) and indocyanine green angiography (ICGA) were retrospectively analyzed in 137 eyes of 123 exudative AMD patients and 42 eyes of 48 PCV patients. Results In 137 eyes of exudative AMD, FFA showed that 16 eyes were typical choroidal neovascularization (CNV), accounting for 11.7%. One eye was occult CNV12, accounting for 88.3%. In the eyes of occult CNV, 42 spots showed hot spots fluorescence in ICGA examination, accounting for 34.7%; 74 eyes showed late patchy fluorescence, accounting for 62.2%; CNV and PCV coexisted in 2 eyes, Accounting for 1.7%. In 8 eyes of 8 PCV, fundus color images of 7 eyes showed distinctive retinal orange-red nodular lesions, accounting for 14.6%. FFA of 2 eyes showed branched choroidal network and polypoid lesions, accounting for 4 .2%; 36 eyes of ICGA showed aberrant branch choroid network and its distal polypoid dilatation, accounting for 75.0%; 12 eyes ICGA showed multiple polypoid foci but not associated with branched choroidal blood vessels Network, accounting for 25.5%. There were 16 eyes (33.3%) with polyp lesions in grapes appearance, 32 eyes (66.6%) with multiple coexisting lesions. Late part of the polyp lesions of the lesion dye leakage or staining, some were polypoid lesion center for weak fluorescence, the surrounding circular staining of the “erosion phenomenon.” Conclusions The different ICGA manifestations of exudative AMD and PCV and the characteristic subretinal orange-red nodules of PCV