[1]李娟娟,黎铧,胡竹林,等.年龄相关性黄斑变性中视网膜色素上皮脱离的临床观察[J].眼科新进展,2018,38(10):972-976.[doi:10.13389/j.cnki.rao.2018.0230]
 LI Juan-Juan,LI Hua,HU Zhu-Lin,et al.Retinal pigment epithelium detachment in age - related macular degeneration[J].Recent Advances in Ophthalmology,2018,38(10):972-976.[doi:10.13389/j.cnki.rao.2018.0230]
点击复制

年龄相关性黄斑变性中视网膜色素上皮脱离的临床观察/HTML
分享到:

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
38卷
期数:
2018年10期
页码:
972-976
栏目:
应用研究
出版日期:
2018-10-05

文章信息/Info

Title:
Retinal pigment epithelium detachment in age - related macular degeneration
作者:
李娟娟黎铧胡竹林张利伟
650021 云南省昆明市,云南省第二人民医院眼科
Author(s):
LI Juan-JuanLI HuaHU Zhu-LinZHANG Li-Wei
Department of Ophthalmoloy,No.2 People’s Hospital of Yunnan Province,Kunming 650021,Yunnan Province,China
关键词:
年龄相关性黄斑病变视网膜血管瘤样增生息肉样脉络膜血管病变脉络膜新生血管多模式影像检查
Keywords:
age-related macular degenerationretinal angiomatous proliferationpolypoidal choroidal vasculopathychoroidal neovascularizationmultimodal fundus imaging
分类号:
R774.5
DOI:
10.13389/j.cnki.rao.2018.0230
文献标志码:
A
摘要:
目的 探讨年龄相关性黄斑病变(age-related macular degeneration,AMD)中不同病变类型视网膜色素上皮脱离(pigment epithelial detachment,PED)的特征,以期为AMD不同类型的诊断及预后评估提供参考依据。方法 通过影像学检查将96例(124眼)患者分为视网膜血管瘤样增生(retinal angiomatous proliferation,RAP)、息肉样脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)、脉络膜新生血管(choroidal neovascularization,CNV)。通过光学相干断层扫描(optical coherence tomography,OCT)结合眼底彩色照相、眼底荧光素血管造影、眼底自发荧光等检查方法对以上几类病变中PED大小、形态、病变性质、预后等重要特征进行回顾分析并对比总结。结果 96例患者中RAP-PED为10例(10.42%)、PCV-PED为32例(43.75%)、CNV-PED为54例(45.83%)。RAP-PED多为浆液性、双眼发病。PCV-PED多为多灶性、出血性,且多为单眼发病。CNV-PED的数量形态表现多样,大小不等相连,形成“波浪样”外观。结论 加深对各类型AMD中PED发生的几率、类型、合并症以及预后等的认识,有助于更为精确指导诊断治疗及预后分析。
Abstract:
Objective To investigate the characteristics of pigment epithelial detachment (PED) in different types of age-related macular degeneration (AMD) in order to provide reference for different types of diagnosis and prognosis of AMD.Methods Totally 96 patients (124 eyes) were divided into patients with retinal angiomatous proliferation (RAP),polypoidal choroidal vasculopathy (PCV),choroidal neovascularization (CNV) by imaging examination.Important features such as PED size,morphology,lesion properties,and prognosis in the above types of lesions by optical coherence tomography (OCT),fundus color photography,fundus fluorescein angiography,and fundus autofluorescence were compared and summarized.Results Together 98 patients included 10 cases of RAP-PED (10.42%),32 cases of PCV-PED (43.75%) and 54 cases of CNV-PED (45.83%).RAP-PED mostly were serous and binocular.PCV-PED were mostly multifocal,hemorrhagic,and monocular different from RAP-PED.The number of CNV-PED was diverse,which was generally different from the other two types of isolated morphology,CNV-PED forming a “wavy” appearance.Conclusion Deepening the understanding of the incidence,types,complications,and prognosis of PED in various types of age-related maculopathy will guide the diagnosis,treatment and prognosis analysis accurately.

参考文献/References:

[1] GONZALEZ A,KHURSHID G.Treatment of retinal pigment epithelial detachment secondary to exudative age-related macular degeneration[J].Am J Ophthalmol Case Rep,2017,9(12):18-22.
[2] PARODI M B,DONATI S,SEMERARO F,DANZI P,INTROINI U,VIOLA F.Intravitreal anti-vascular endothelial growth factor drugs for retinal angiomatous proliferation in real-life rractice[J].J Ocul Pharmacol Ther,2017,33(2):123-127.
[3] LEHMANN B,HEIMES B,GUTFLEISCH M,SPITAL G,PAULEI-KHOFF D,LOMMATZSCH A.Serous vascularized pigment epithelial detachment in exudative AMD.Morphological typing and risk of tears in the RPE[J].Ophthalmologe,2015,112(1):49-56.
[4] DONATI M C,CARIFI G,VIRGILI G,MENCHINI U.Retinal angiomatous proliferation:association with clinical and angiographic features[J].Ophthalmologica,2006,220(1):31-36.
[5] SUN Z H,WEN F,CHEN Y L,WU D Z,HUANG S Z,LUO G W,et al.Characteristic shanges of ocular fundus of retinal pigment epithelial detachment in Chinese patients more than 50[J].Chin J Ocul Dis,2006,22(4):224-227.
孙祖华,文峰,陈艳丽,吴德正,黄世洲,罗光伟,等.50岁以上患者视网膜色素上皮脱离的眼底特证分析[J].中华眼底病杂志,2006,22(4):224-227.
[6] LEE W K,PARK Y H,LEE P Y.Neovascularization associated with large retinal pigment epithelial detachment in elderly Korean patients:subdivision according to indocyanine green angiographic features[J].Jpn J Ophthalmol,2007,51(3):216-223.
[7] HAN L,MA Z,WANG C,HU Y,JIN Y.Morphologic features and viability analysis of human detached retinal pigment epithelium in age-related macular degeneration[J].Am J Ophthalmol,2013,155(3):474-448.
[8] YANNUZZI L A,NEGRO S,IIDA T,CARVALHO C,RODRIGUEZ-COLEMAN H,SLAKTER J,et al.Retinal angiomatous proliferation in age-related macular degeneration[J].Retina,2012,32(2):416-434.
[9] BRESSLER N M,SILVA J C,BRESSLER S B,FINE S L,GREEN W R.Clinicopathologic correlation of drusen and retinal pigment epithelial abnormalities in age-related macular degeneration[J].Retina,2005,25(5):130-142.
[10] PAULEIKHOFF D,LFFERT D,SPITAL G,RADERMACHER M,DOHRMANN J,LOMMATZSCH A,et al.Pigment epithelial detachment in the elderly.Clinical differentiation,natural course and pathogenetic implications[J].Graefes Arch Clin Exp Ophthalmol,2002,240(7):533-538.
[11] TAN A C,SIMHAEE D,BALARATNASINGAM C,DANSINGANI K K,YANNUZZI L A.A perspective on the nature and frequency of pigment epithelial detachments[J].Am J Ophthalmol,2016,172(1):13-27.
[12] KWOK A K,LAI T Y,CHAN C W,NEOH E L,LAM D S.Polypoidalchoroidalvasculopathy in Chinese patients[J].Br J Ophthalmol,2002,86(8):892-897.
[13] ALASIL T,FERRARA D,ADHI M,BREWER E,KRAUS M F,BAUMAL C R,et al.En face imaging of the choroid in polypoidalchoroidalvasculopathy using swept-source optical coherence tomography[J].Am J Ophthalmol,2015,159(4):634-643.
[14] RAVERAV,BOTTONI F,GIANI A,CIGADA M,STAURENGHI G.Retinal angiomatous proliferation diagnosis:A multiimaging approach[J].Retina,2016,36(12):2274-2281.
[15] BARKMEIER A J,CARVOUNIS P E.Retinal pigment epithelial tears and the management of exudative age-related macular degeneration[J].Semin Ophthalmol,2011,26(3):94-103.
[16] GUBER J,PRAVEEN A,SAEEDMU.Retinal pigment epithelium rips after ranibizumab in neovascular age-related macular degeneration:incidence,risk factors and long-term outcome[J].Klin Monbl Augenheilkd,2014,231(4):432-435.

相似文献/References:

[1]董志章,李娟,孙雪荣,等.高强度光照损伤致TgAPPswePS1转基因鼠脉络膜新生血管形成[J].眼科新进展,2017,37(2):101.[doi:10.13389/j.cnki.rao.2017.0027]
 DONG Zhi-Zhang,LI Juan,SUN Xue-Rong,et al.Intensive light exposure inducing choroidal neovascularization in TgAPPswe/PS1 transgenic mice[J].Recent Advances in Ophthalmology,2017,37(10):101.[doi:10.13389/j.cnki.rao.2017.0027]

备注/Memo

备注/Memo:
云南省医疗卫生单位内设研究机构科研项目(编号:2017NS131);云南省卫生和计划生育委员会医学后备人才培养计划(编号:H-201636)
更新日期/Last Update: 2018-09-28