Objecttve To investigate the clinical features of choroidal neovascularization (CNV) in different classifications.Methods In this retrospoctive case series,393 eyes of 312 patients with CNV between May 2005 and March 2007 in our department was classified based on their etiology,location,fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) findings.Results The relative frequency of various causes in CNV was as follows:there were 153 cases (49.04%) from age-related macular degeneration (AMD),94 cases (30.13%) from idiopathic CNV,37 cases (11.86%) from pathologic myopia,15 cases (4.81%) from inflammatory disorders,7 cases (2.24%) from polypoidal choroidal vasculopathy (PCV),3 cases (0.96%) from angioid streaks and 1 case (0.32%) from either hereditary disease or trauma or tumor,respectively.The majority cases from AMD was male (64.71%),whereas most from pathologic myopia,idiopathic CNV and inflammatory disorders were female (78.38%,73.40%,73.33%).The age range of the cases from AMD was 49-95 years (68.73±8.31),and 98.04% of them were at least 50 years old. Patients with idiopathic CNV aged 13-43 years old (29.86±6.45),and 84.04% of them were between 20 and 40 years old.The sex (χ2=57.17,P＜0.05) and age (F=172.57,P＜0.05) had significant difference in each etiological group.FFA showed that CNV in 43.48% from AMD and 66.67% from PCV were occult and non-classic.CNV in 91.67% from pathologic myopia,76.19% from inflammatory disorders and 95.00% from idiopathic CNV was classic.In each group,most of the CNV was subfoveal type (58.00%-100.00%),followed by iuxtafoveal type (0%-35.00%).In the ICGA of 54 eyes with AMD,11 eyes (20.37%) were occult CNV (plaque,spot and mixed CNV),17 eyes (31.48%) were CNV fibrosis.CNV was active in most cases.The frequency of active and inactive CNV in AMD was approximately 61.11% and 37.04%,respectively,no lesions were noted in 1 eye (1. 85%) in ICGA.Conclusions The clinical characteristics and frequency of various types of CNV are different due to different causes.Classification of CNV based on its etiology,FFA and ICGA findings,location,and activity in detail is important for the diagnosis,treatment and prognosis judgment in CNV.%目的 研究不同分类方法中脉络膜新生血管(CNV)的病变特征.方法 回顾性系列病例研究.收集2005年5月至2007年3月共312例(393只眼)CNV患者的临床资料,根据其CNV病因、荧光素眼底血管造影(FFA)和吲哚氰绿血管造影(ICGA)图像特征及病灶活动性进行分类,总结不同分类方法中CNV的病变特征.应用SPSS 10.0统计学软件进行数据分析.各病因组患者年龄间比较采用单因素多水平设计定量资料方差分析,各病因组患者性别差异采用列联表χ2检验.以P＜0.05作为差异有统计学意义.结果 CNV病因学分类:年龄相关性黄斑变性(AMD)CNV 153例(49.04%),特发性CNV 94例(30.13%),病理性近视CNV 37例(11.86%),炎性反应CNV 15例(4.81%),特发性息肉状脉络膜血管病变(PCV)CNV 7例(2.24%),血管样条纹CNV 3例(0.96%),遗传性、外伤性眼病及眼肿瘤性CNV各1例(0.32%).继发于AMD的CNV中男性99例(64.71%);而病理性近视、特发性CNV及炎性反应CNV中则以女性患者居多,分别为29例(78.38%)、69例(73.40%)、11例(73.33%).继发于AMD的CNV患者年龄49～95岁,平均(68.73±8.31)岁,50岁以上患者150例(98.04%);特发性CNV患者年龄13～43岁,平均(29.86±6.45)岁,其中20～40岁79例(84.04%).各病因组患者性别(χ2=57.17,P＜0.05)和年龄(F=172.57,P＜0.05)差异有统计学意义.FFA检查的分类结果中,AMD、PCV多为隐匿非典型性CNV(43.48%、66.67%),病理性近视、炎性反应和特发性CNV则多为完全典型性CNV(91.67%、76.19%及95.00%).各组中CNV均以黄斑中心凹下型为最多(58.00%～100.00%),其次为黄斑中心凹旁型(小于35.00%).依据ICGA中CNV形态,各病因组中CNV均以典型性表现为主.ICGA检查继发于AMD的CNV 54只眼中,隐匿性CNV(斑状、焦点状及混合性CNV)11只眼(20.37%),CNV瘢痕化17只眼(31.48%).各病因组中以活动性CNV为主.继发于AMD的CNV中,活动性CNV 33只眼(61.11%),静止性CNV 20只眼(37.04%),未显影1只眼(1.85%).结论 不同病因导致的CNV患者在年龄、性别及各分类中差别较大,FFA和ICGA图像特征与病灶活动性亦不相同.全面细致分类对CNV病因学诊断、综合治疗及判断预后有重要意义.
展开▼
