视网膜中央静脉阻塞并发渗出性视网膜脱离的临床特征

Clinical features of central retinal vein occlusion complicating exudative retinal detachment

目的探讨视网膜中央静脉阻塞并发渗出性视网膜脱离患者的临床特征.方法回顾性分析视网膜中央静脉阻塞并发渗出性视网膜脱离患者的一般情况及视力、眼压、眼底、荧光素眼底血管造影、眼部超声波等检查资料.结果15例患者中,男性8例,女性7例;年龄18～42岁,平均25岁.5例合并新生血管性青光眼.患者就诊时的视力：光感至0.05.眼底检查显示全视网膜散在出血、视网膜静脉迂曲,黄斑区有明显的水肿和出血,在水肿和脱离区的边缘可见大片渗出.坐位时视网膜脱离为2～5个钟点范围.全部患者均未见视乳头血管吻合支的形成.荧光素眼底血管造影显示大片出血遮蔽荧光或可见后极部毛细血管无灌注区.超声波测量有5只眼平均眼轴长为22.98 mm.结论渗出性视网膜脱离是视网膜中央静脉阻塞的少见、严重并发症.多见于青年患者,易并发新生血管性青光眼,其眼底及荧光素眼底血管造影检查具有特征性.

Objective To investigate the clinical features of central retinal vein occlusion （CRVO） complicating exudative retinal detachment （ERD）. Methods General health, vision, intraocular pressure, appearance of the fundus and fundus fluorescein anglography （FFA） and the results of ultrasound examination in cases with CRVO complicating ERD were analyzed. Results Eight patients were male and 7 patients were female. Age of those patients ranged from 18 to 42 years, averaged 25 years. Five cases combined with neovascular glaucoma. Initial vision ranged from 0.05 to light perception. There were notably edema and hemorrhage in the macular region. Extensive exudative appeared at the edge of edema and detachment region. The extent of retinal detachment was 2/12- 5/12 quadrant at sitting position. No collateral vessels were found on the optic disk. FFA showed extensive blockage by the hemorrhages or capillary nonperfusion. Conclusions ERD is a rare and severe complication of CRVO, which usually develops in young patients and combines with neovascular glaucoma. The appearance in fundus and FFA shows a characteristic features. （Chin J Ophthalmol , 2006,42： 492-495）