视网膜黄斑分支静脉阻塞的临床观察和中心凹无血管区面积的测定

Clinical research of macular branch retinal vein occlusion and surveying of the area of foveal avascular zone

目的 观察视网膜黄斑分支静脉阻塞 (macular branch retinal vein occlusion,MBRVO)眼的临床特点以及黄斑中心凹无血管区 (foveal avascular zone,FAZ)面积的改变。 方法 回顾分析检眼镜、Goldmann三面镜和裂隙灯显微镜及荧光素眼底血管造影 (fundus fluorescein angiography,FFA)等检查确诊的 MBRVO患者 6 9例 6 9只眼的临床资料 ,观察分析阻塞处动静脉的位置关系、眼底及 FFA特点和并发症等临床特征。并对其中 36例病程 3～ 6个月的 MBRVO患者及 30名正常对照者采用 Heidelberg激光扫描眼底荧光造影系统测定的 FAZ面积资料进行对比分析。 结果 6 9例 MBRVO发生于黄斑上支者 4 5只眼 ,占 6 5 .2 2 % ,黄斑下支者 2 4只眼 ,占 34.78%。阻塞处动脉多位于静脉之上 ,眼底及 FFA检查可见 4种不同的临床类型 ,主要的并发症为黄斑水肿。MBRVO患者的 FAZ面积较正常人明显扩大 (P<0 .0 5 )。 结论 MBRVO有其自身特点 ,临床表现多样 ,FAZ的面积较正常人明显扩大。

Objective To observe the clinical characteristics of patients with macular branch retinal vein occlusion (MBRVO) and the changes of the area of foveal avascular zone (FAZ). Methods The data of 69 eyes of 69 patients with MBRVO , who had been diagnosed by ophthalmoscopy, slit-lamp examination and fluorescein angiography, were retrospectively studied. The relationship of locations between artery and vein on the obstructive site, and the characteristics of fundus pictures, retinal vasculature changes and the complications were analyzed. In 69 patients with MBRVO, 36 had the course of disease for more than 3-6 months, of whom the area of FAZ was compared with that of 30 healthy people. Results In 69 patients, superior MBRVO occurred in 45 eyes (65.22%), and inferior MBRVO occurred in 24 eyes (34.78%). Most of the arteries were anterior to the veins at the obstructive site. Four clinical types of MBRVO were found, and the main complication was macular edema. There was a significant difference in area of FAZ between patients with MBRVO and healthy people (P<0.05). Conclusion There are several clinical characteristics of MBRVO with different manifestations. The area of FAZ of patients with MBRVO is obviously lager than that of the healthy people.