视网膜中央动脉伴中央静脉阻塞的病因与治疗

Etiology and treatment of combined central retinal artery and vein occlusion

本文通过查阅文献与本人实践,列举了视网膜中央动脉伴中央静脉阻塞的病因。老年人常伴有心血管高危因素,如高血压、高血脂、糖尿病、颈动脉粥样硬化等。年轻患者若无心血管高危因素而发生此病,应进一步追查病因,包括感染性与非感染性血管炎、自身免疫性疾病(如系统性红斑狼疮)、血液高凝状态(如抗磷脂抗体综合征)以及少见的白血病、淋巴瘤或转移癌浸润视神经,继而压迫视网膜中央动、静脉。通过收集病史,结合眼部、实验室、影像学检查,对极为困难的病例,可采用视神经活检的方法,可达到病因诊断的目的。治疗主要针对病因。

Literature review combined with my own practice,varied causes of combined central retinal vein and artery occlusion are evaluated. Cardiovascular risk factors includes arterial high blood pressure,hyperlipidemia,diabetic mellitus（ DM）,carotid atherosclerosis prevail in elderly individuals with the disease. For young patients without cardiovascular factors,more attention should pay to infectious and non-infectious vasculitis,autoimmune diseases such as systemic lupus erythematosus,hypercoagulability status as antiphospholipid antibody syndrome and rarely optic nerve infiltration by leukemia,lymphoma and metastatic carcinoma should be considered. History taken,together with eye examination,laboratory analysis and image evaluation and lastly,optic nerve biopsy for the most difficult cases could provide information for diagnosis. Treatment is based on the causes found accordingly.