首发表现为玻璃体积血视网膜分支静脉阻塞临床特点

The diagnosis and clinical characteristics of vitreous hemorrhage in branch retinal vein occlusion as the first symptom

目的 探讨首发症状为玻璃体积血视网膜分支静脉阻塞（BRVO）的荧光素眼底血管造影（FFA）诊断及临床特点.方法 回顾性分析2009年1月至2011年12月在秦皇岛市第一医院眼科以玻璃体积血为首发症状而就诊的97例97只眼BRVO病例的FFA特点及临床资料.结果 97只眼玻璃体积血分别为：Ⅰ级玻璃体积血38只眼,占39.18％ （38/97）.Ⅱ、Ⅲ级玻璃体积血59只眼,占60.82％ （59/97）.发现视网膜血管白鞘67只眼,占69.07％ （67/97）.全部病例经FFA检查明确诊断为BRVO,FFA显示阻塞区毛细血管大片闭塞,阻塞区边缘毛细血管瘤样扩张.其中81只眼,占83.51％ （81/97）,发现大小、数量不等的视网膜新生血管.颞上BRVO 66只眼,占68.04％ （66/97）.颞下BRVO 13只眼,占13.40％ （13/97）.鼻上BRVO 11只眼,占11.34％ （11/97）.鼻下BRVO 7只眼,占7.22％（7/97）.阻塞静脉分支级别为：一级分支18只眼,均为鼻侧静脉分支,占18.56％ （18/97）.二、三级分支79只眼,均为颞侧静脉的周边分支,占81.44％（79/97）.伴增殖膜13只眼,占13.40％ （13/97）.继发视网膜浅脱离10只眼,占10.31％ （10/97）.结论 首发症状为玻璃体积血的BRVO病例,静脉分支均为鼻侧静脉分支及颞侧静脉分支中的周边分支.发生玻璃体积血前均无症状.玻璃体积血多为Ⅰ级-Ⅲ级.FFA可明确诊断.发病人群为伴有高血压病的中老年.

Objective To investigate the diagnosis and clinical characteristics of vitreous hemorrhage in branch retinal vein occlusion（BRVO）fundus fluorescein angiography（FFA）as the first symptoms.Methods A retrospective analysis of the FFA characteristics and clinical data of 97 cases（97 eyes）with BRVO cases which had vitreous hemorrhage as the first symptom treatment.Results Of 97 eyes of vitreous hemorrhage,respectively：Class I vitreous hemorrhage 38,accounted for 39.18%,Class Ⅱ,Ⅲ vitreous hemorrhage 59,accounted for 60.82%.Retinal vascular white sheath 67,accounted for 69.07%.All patients were BRVO with clear diagnosis by FFA.FFA showed that there was occlusion area capillary large block,block area edge to expand capillary tumor samples in all cases.The size and number of retinal neovascularization were found in 81 eyes（83.51%）,BRVO 66 eyes on the temporal,accounted for 68.04%; Under the temporal BRVO 13 eyes 13 eyes,accounted for 13.40%; On the nose of BRVO 11 eyes,accounted for 11.34%; Under the nose of BRVO 7 eyes,accounted for 7.22%.Blocking venous branch level：Primary branches were 18 eyes,which were a branch the nasal vein branches,accounted for 18.56%.Secondary and tertiary branches were of 79 eyes,which were peripheral branch of the temporal side of the vein,accounted for 81.44%.With proliferation of membrane 13 eyes,accounted for 13.40%; retinal detachment 10,accounted for 10.31%.Conclusions BRVO cases of vitreous hemorrhage as the first symptom are the peripheral branch of the nasal vein branch retinal vein branch and the temporal side of the vein branches and are asymptomatic before the vitreous hemorrhage,vitreous hemorrhage for grade Ⅰ-Ⅲ level.FFA can confirm the diagnosis.The crowd of the disease has occurred among middle-aged and old hypertension.