Ⅱ型视盘血管炎与视网膜中央静脉阻塞临床对比分析

COMPARISON AND ANALYSIS OF ODV AND CRVO

①目的观察Ⅱ型视盘血管炎(ODV)与视网膜中央静脉阻塞(CRVO)在临床特征与荧光血管造影等方面的异同点,以期正确区分ODV,提高其治疗效果。②方法回顾性地分析了12例ODV与30例CRVO病人在病因、临床表现、荧光血管造影(FFA)、治疗及预后等方面的特点。③结果ODV病人多为青壮年,无高血压、糖尿病等全身疾病史,视力≥0.5(含矫正视力),皮质类固醇类药物治疗敏感,勿需激光治疗,预后较好,FFA检查未见毛细血管无灌注区;CRVO病人多见于中老年,多伴有高血压、动脉硬化、糖尿病等全身疾病史,视力下降明显,多数视力<0.1,甚至数指或眼前手动,皮质类固醇类药物治疗无效,预后差,FFA多可见毛细血管无灌注区,病史长者可见新生血管形成。④结论Ⅱ型ODV极易误诊为CRVO,因两者的治疗方式及预后不同,因此,临床上通过二者的病因及辅助检查为其诊断提供依据。

Objective To investigate the similarities and differences of clinical characteristics and FFA between type Ⅱ ODV and CRVO. Methods Respective characteristics in etiological factors, clinical characteristics, FFA, treatment and prognosis of 12 cases of type Ⅱ ODV and 30 cases of CRVO were analyzed retrospectively. Results Type Ⅱ ODV existed mainly in young adults without hypertension, diabetes mellitus or other systematic diseases, with the eye sights ≥ 0. 5 （adjusted sights included）, sensitive to hormone treatment, the prognosis was good. CRVO was mainly seen in elder adults with hypertension, arteriosclerosis, diabetes mellitus or other systematic diseases, with the eye sights decreased evidently （0.1）. Hormone did not help, the prognosis of the lesion was poor. Capillary non-perfusion areas commonly existed in FFA. Conclusion Type Ⅱ ODV is usually misdiagnosed as CRVO. The treatment and prognosis of them are different. Clinically, the diagnosis of both the disease can be made through etiological factors and adjuvant examinations.