关键词: 黄斑中心凹旁渗出性血管异常复合体, 相干光断层扫描血流成像, 微脉冲激光光凝

Abstract: Objective  To summarize the clinical features of parafoveal exudative vascular anomalous complex(PEVAC). Design Retrospective case series. Participants Twelve eyes of 12 patients with PEVAC in Beijing Tongren Hospital from 2014 to 2022. Methods The clinical data and medical records of the enrolled patients were collected, including best-corrected visual acuity (BCVA), slit-lamp examination, ophthalmoscopy, color fundus photograph (CFP), optical coherence tomography (OCT), OCT angiography (OCTA), fundus fluorescence angiography(FFA). Main Outcome Measures Findings and manifestations on CFP, OCT, OCTA and FFA. Results Twelve patients were all subjected to monocular onset, with a mean age of (57±13) years old. The follow-up period ranged from 2 to 72 months, with an average of [8(5, 35)] months. Hard exudation and cystoid macular edema (CME) were respectively seen in 6 patients (50%), and only 1 patient (8.3%) was accompanied with parafoveal hemorrhage. The foveal retinal thickness was 197 to 422 μm with an average of [218(210, 286)] μm. The horizontal distance of the aneurysmal lesion to the central fovea ranged from 241 to 843 μm with an average of (527±205) μm, whereas horizontal distances to the fovea in 7 patients (58.3%) were less than 500 μm. All the patients suffered from the parafoveal isolated aneurysmal lesion with a mean diameter of [113(96,119)] μm ranging from 84 to 329 μm. The aneurysmal lesion of 9 patients (75.0%) were located at deep retinal capillaries. Two patients underwent intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection treatment, of which 1 patient was aggravated after intravitreal anti-VEGF. One patient was subjected to a micropulse laser treatment due to the failure of twice continuous intravitreal injection, and CME was relieved 1 month after giving a micropulse lasertreatment. Besides, the CME of another patient spontaneously subsided during follow-up, however, the diameter of the aneurysmal lesion in one patient was gradually dilatated. One patient was complicated with chronic angle closure glaucoma. Conclusions PEVAC is commonly manifested as a monocularly parafoveal isolated aneurysmal lesion, often located in the deep retinal capillary. The aneurysmal lesion either subsided or gradually expanded and CME can spontaneously resolve. （Ophthalmol CHN, 2022, 31: 458-462）

Key words:  parafoveal exudative vascular anomalous complex, optical coherence tomography angiography, micropulse laser treatment