22例颈动脉海绵窦瘘的眼部表现临床分析

Clinical analysis of 22 cases with ocular symptoms of carotid cavernous fistula

目的分析颈动脉海绵窦瘘眼部表现的临床特点,提高眼科医生对该病的认识。方法收集2011-01—2017-03首诊于眼科的22例颈动脉海绵窦瘘患者,男14例,女8例,年龄16~66岁,平均40.09岁。回顾性分析眼部症状及治疗的疗效。结果眼部临床表现:眼球突出20例(90.9%),结膜充血水肿15例(68.2%),眼睑水肿5例(22.7%),眼球运动受限7例(31.8%),流泪3例(13.6%),眼眶杂音3例(13.6%),视力下降6例(27.3%),眼压升高3例(13.6%),眼痛4例(18.2%),视物重影3例(13.6%)。颈动脉海绵窦瘘介入栓塞术治病18例,随访1~6个月,其中治愈4例,好转12例,无效或失败2例。保守治疗4例,随访6个月,4例全部好转。结论颈动脉海绵窦瘘的临床表现多样,其中眼球突出、结膜充血水肿最常见。

Objective To analyze the clinical manifestation of ocular symptoms caused by carotid cavernous fistula （CCF）, to improve the ophthalmologist for the understanding of the disease. Methods The clinical data of 22 patients with CCF from Jan- uary 2011 to March 2017 in our hospital was analyzed retrospectively. Include 14 cases of male and 8 females,from 16 to 66 years old, an average of 40. 09 years old. Results Manifestation of ocular symptoms include.. 22 （90.9 %）patients with exophthalmos, 15 （68.2~/oo） with conjunctival congestion and chemosis, 5 （22.70/oo） with edema of eyelids, 7 （31.8~/oo） with limit of ocular move- ments,3 （13.6%） with lacrimation, 3 （13.6~/oo） with orbital noise,6 （27.3 %） with loss of vision,3 （13.6%） with increased in- traocular pressure,4 （18.2%） with eye pain,3 （13.6%） with diplopia. 18 cases with endovascular treatment. All cases were fol- lowed up from 1 to 6 months,4 cases were treated successfully and cured, 6 cases were symptoms improved, 2 cases treatment fail- ure. Conservative treatment in 4 cases, all symptoms improved. Conclusion The clinical manifestations of carotid cavernous fistula are varied. Conjunctival congestion and exophthalmos were the most frequent ocular symptoms caused by CCF.