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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 2 0 0 0年 10月～ 2 0 0 3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 4 5 .3% ;4 1只眼未见 RCA,占 5 4 .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 .5 2 90 )。无 RCA形成的 33只 PED患眼中 ,发生 PED裂孔者 17只眼 ,占 5 1.5 % ;有RCA形成的 30只 PED患眼中 ,发生 PED裂孔者 2 6只眼 ,占 86 .7% ,二者比较 ,差异有显著性的意义(χ2 =8.96 12 ,P=0 .0 0 30 )。 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。
Objective To investigate the relationship between age-related macular degeneration (AMD) retinal choroidal vascular anastomosis (RCA) and retinal pigment epithelial detachment (PED). Methods A retrospective analysis of 70 eyes of 75 exudative AMD patients diagnosed from October 2000 to December 2003 with optical coherence tomography (OCT) and fundus angiography was performed to observe the presence or absence of RCA And the relationship with the PED. Results Of 75 eyes with exudative AMD, RCA was found in 34 eyes, accounting for 45.3%. There was no RCA in 41 eyes, accounting for 54.7%. There were 30 patients with PAD with RCA formation, accounting for 88.2%; 4 eyes without PED, accounting for 11.8%. There were 33 eyes with PED without RCA, accounting for 80.5%; 8 eyes without PED, accounting for 19.5%. There was no significant difference in the incidence of PED with or without RCA (χ2 = 0.83, P = 0.252 90). Of the 33 PED patients without RCA, 17 had PED and accounted for 51.5%. In the 30 PED patients with RCA, 26 eyes with PED and 86.7% The difference was significant (χ2 = 8.96 12, P = 0.030). Conclusions It is not uncommon for RCA to form in patients with exudative AMD. RCA often coexists with PED, but there is no direct causal relationship between the two. The occurrence of PED is closely related to the formation of RCA.