先天性视网膜血管行径异常106例临床观察

Investigation of congenital retinal vascular anomalies in 106 cases

目的观察106例先天性视网膜血管发育异常的临床特征、分布及构成情况、对视力造成影响原因等。方法收集1998年1月至2013年12月在云南省第二人民医院眼科诊治的先天性视网膜血管发育异常的患者106例，对其眼底、眼底荧光血管造影特征、视力情况等临床资料进行分析。结果106例（170只眼）患者中26例（52只眼）先天性视网膜血管分支异常，占总眼数的30．6％；31例（56只眼）先天性视网膜血管走行异常，占总眼数的32．9％；17例（19只眼）为先天性异常黄斑血管，占总眼数的11．2％；21例（21只眼）为先天性视盘血管袢，占总眼数的12．4％；11例（22只眼）先天性视网膜血管迂曲扩张，占总眼数的12．9％。106例患者中2例（3只眼）因视网膜血管异常分支走行经过黄斑中心凹处而视力不佳，2例（2只眼）因视盘小血管袢出血遮挡黄斑的患者视力下降明显、排除其他合并症，余患者视力均未受影响。结论先天性视网膜血管异常发病率极低，但表型多样，大部分先天性视网膜血管异常并不导致视力障碍。

Objective To investigate clinical characteristics, distribution of congenital retinal vas- cular abnormalities in and the impaction on visual acuity. Methods One hundred and six cases of congenital retinal vascular abnormalities were collected, the characteristics of fundus, fundus fluoresce- in angiography, visual conditions and other clinical data were analyzed. Results The abnormal bifur- cation of retinal vascular was seen in 26 cases （52 eyes）, the abnormal tracks of retinal vessels were seen in 31 cases （56 eyes）, abnormal macular vessels were seen in 17 cases （19 eyes）, congeni- tal prepapillary vascular loops were seen in 21 cases （21 eyes）. Retinal vascular tortuosity was seen in 11 cases （22 eyes）. The visual acuity were damaged in 2 cases （3 eyes） due to the branch ves- sels go through the macular fovea, the visual acuity of 2 cases （2 eyes） were damaged due to the hemorrhage in prepapillary loops. The visual function was normal in other patients. Conclusions The incidence of congenital retinal vascular abnormalities was low, but the phenotype was varied, the majority of congenital retinal vascular abnormalities did not influence visual acuity.