摘要目的 研究息肉样脉络膜血管病变(PCV)异常血管网和息肉样病变的频域相干光断层扫描(OCT)图像特征.方法 回顾性病例系列研究.对经吲哚氰绿脉络膜血管造影(ICGA)确诊的54例(63只眼)PCV患者的临床资料进行回顾性分析,观察其脉络膜异常血管网和息肉样病变的频域OCT图像特征.结果 ICGA图像中,有45只眼同时可见脉络膜异常血管网和血管息肉样扩张,8只眼仅见脉络膜异常血管网,10只眼仅见脉络膜血管息肉样扩张.53只眼异常血管网相对应部位均可见视网膜色素上皮层隆起,其中38只眼显示视网膜色素上皮层呈扁平波纹状隆起,视网膜色素上皮层信号与Bruch膜信号之间可见中至高的异常血管网反射信号;15只眼视网膜色素上皮层隆起较高,其下可见中高反射异常血管网和(或)出血信号,Bruch膜信号不完整.55只眼脉络膜息肉样病灶中,有28只眼为孤立性病灶,频域OCT图像显示为局限、轻度隆起的视网膜色素上皮层与Bruch膜之间的中等反射信号;27只眼ICGA图像显示为聚集性息肉样病变,而在频域OCT图像中表现为圆顶形、高度隆起的视网膜色素上皮层脱离,其下可见中等反射信号.结论 PCV异常血管网和息肉样病变大多表现为视网膜色素上皮层和Bruch膜之间的中高反射信号.

abstractsObjective To analyze the tomographic features of branching vascular networks and polypoidal lesions in patients with polypoidal choroidal vasculopathy (PCV) by spectral domain optical coherence tomography (SD-OCT). Methods It was a retrospective case series study. Retrospective review of 63 eyes of 54 patients with PCV identified with indocyanine green angiography (ICGA). Tomographic features of branching vascular networks and polypoidal lesions on SD OCT,ICGA and fluorescein angiography were analyzed. Results Both branching vascular network and polypoidal lesions were found in 45 eyes on ICGA,branching vascular network only was found in 8 eyes and polypoidal lesions only in 10 eyes. Retinal pigment epithelial detachment (RPED) was found in all 53 eyes with branching vascular networks on SDOCT. Thirty-eight eyes had areas of moderate reflectivity of branching vascular network between the fluctuating retinal pigment epithelium and Bruch membrane. Fifteen eyes had moderate reflectivity of branching vascular network and/or hemorrhage between high doom-like RPED and incomplete Bruch membrane. Solitary pelypoidal lesions in 28 patients showed local moderate reflectivity between the RPE and Bruch membrane on SDOCT. Other aggregate polypoidal lesions in 27 patients showed moderate reflectivity between high doom-like RPED and incomplete Bruch membrane. Conclusion The vascular abnormalities of PCV identified with ICGA were visualized on SD-OCT images as areas of moderate reflectivity between RPE and Bruch membrane.