视网膜中央静脉阻塞伴视盘水肿与黄斑水肿相关性分析

Association of papilloedema and macular edema in central retinal vein occlusion

目的研究视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)患者发生视盘水肿程度与黄斑水肿程度的相关性。方法回顾分析我院经荧光素眼底血管造影确诊不伴其他视网膜疾病的CRVO患者113例(113眼),以荧光素眼底血管造影(60±30)s时间点视盘荧光情况及造影后期黄斑荧光情况分别对视盘水肿及黄斑水肿程度进行分级、分型;同时应用双变量等级相关分析方法对其进行相关性分析。结果93.81%(106/113)的CRVO患眼发生视盘水肿,87.61%(99/113))的CRVO患眼发生黄斑水肿。113眼中未发生视盘水肿者占6.19%(7/113),轻度视盘水肿者占19.47%(22/113),中度视盘水肿者占41.59%(47/113),重度视盘水肿者占32.74%(37/113)。未发生黄斑水肿的14眼中7眼无视盘水肿,3眼轻度视盘水肿,4眼中度视盘水肿,无重度视盘水肿。黄斑水肿程度与视盘水肿程度呈正相关(r=0.588,P<0.001)。结论绝大多数CRVO患眼可出现视盘水肿,视盘水肿可能在黄斑水肿出现之前发生;视盘水肿的程度与黄斑水肿的程度呈正相关,视盘水肿的严重程度可能是影响黄斑水肿程度的一个重要因素。

Objective To investigate the correlation between the levels of papilloedema and macular edema in central retinal vein occlusion（CRVO）.Methods Retrospectively analysis was taken in 113 patients（113 eyes）with CRVO without other re-tinal disease by fundus fluorescein angiography in our hospital.The levels of papilloedema and macular edema were classified by the condition of visual disk fluorescein at（60±30）s with fundus fluorescein angiography and macular fluorescein after opacification.Correlation of these data were analyzed with bivariant rank correlation analysis.Results The incidence of papilloedema was 93.81%（106 eyes in 113 eyes）and the macular edema was 87.61%（99 eyes in 113 eyes）.In 113 eyes,7 eyes were without papilloedema（6.19%）,22 eyes with mild papilloedema（19.47%）,47 eyes with mode-rate papilloedema（41.59%）and 37 cases with severe papilloedema（32.74%）.In 14 eyes without macular edema,there were 7 eyes without papilloedema,3 eyes with mild papilloedema,4 eyes with moderate papilloedema and no eye with severe papilloedema.The severity of papilloedema had positive correlation with the severity of macular edema（r=0.588,P0.001）.Conclusions Papilloedema may occur in vast majority of patients with CRVO,and can be found before macular edema.The severity of papilloedema is positively correlated with the severity of macular edema.The severity of papilloedema is one of the important factors in affecting the degree of macular edema.