视网膜分支静脉阻塞伴视网膜脱离16例的手术治疗

Surgical treatment of retinal detachment after branch retinal vein occlusion in 16 cases

目的:分析视网膜分支静脉阻塞伴视网膜脱离患者的手术治疗效果及影响因素。方法:回顾性分析视网膜分支静脉阻塞伴视网膜脱离患者16例16眼的手术治疗效果及影响因素,随访6～18mo,观察视力、眼底及视网膜复位情况。结果:视网膜分支静脉阻塞以颞侧分支静脉为主;视网膜裂孔为圆形及马蹄形,均位于牵引点附近,沿血管分布。随访结束后,所有患者视网膜均复位,14眼(88%)视力明显改善,2眼(12%)视力保持不变。视力预后与视网膜裂孔种类、玻璃体后脱离、视网膜新生血管及黄斑部是否脱离密切相关。结论:及时进行视网膜脱离复位及激光光凝术是治疗视网膜分支静脉阻塞伴视网膜脱离的有效方法。

· AIM: To evaluate the surgical efficacy and preoperative factors causing the decreased visual acuity of patients with retinal detachment after branch retinal vein occlusion.· METHODS: Clinical records were reviewed of 16 consecutive patients (16 eyes) who underwent operations for retinal detachment after branch retinal vein occlusion. The fundus feature, visual acuity and retinal reattachment were analyzed and the follow-up periods ranged from 6 to 18mo.· RESULTS: Most patients with retinal detachment after branch retinal vein occlusion had temporal branch retinal vein occlusion. There were 2 types of retinal hiatus in these patients: retinal holes without vitreous traction and retinal tears with vitreous traction. These hiatus were adjacent to tractive points and distributed along occluded blood vessels. All patients achieved total retinal reattachment by the time of final examination. Fourteen eyes (88%) achieved improved visual acuity. But the visual acuity of 2 eyes did not change. The visual acuity prognosis was closely correlative with the types of retinal slit pores, posterior vitreous detachment, retinal neovascularization and macular detachment.· CONCLUSION: Timely retinal reattachment operation and laser photocoagulation are the effective methods to treat the retinal detachment after branch retinal vein occlusion.·