《中国视网膜静脉阻塞临床诊疗路径专家共识》要点解读

Key points interpretation of Expert consensus on clinical diagnosis and treatment path of retinal vein occlusion in China

视网膜静脉阻塞(RVO)是眼科和全身疾病关联密切的疾病。《中国视网膜静脉阻塞临床诊疗路径专家共识》(以下简称为共识)强调诊疗时应首要关注病因诊断与病因治疗,将病因探索置于诊疗路径的重要地位。除病因治疗外,共识强调临床需重点关注眼前节新生血管、新生血管性青光眼和黄斑水肿的处理。特别是对于病程短的视网膜中央静脉阻塞患者,要警惕百日青光眼的发生,并采取积极的抗血管内皮生长因子(VEGF)药物、激光光凝和降眼压治疗。针对黄斑水肿的治疗,共识指出抗VEGF药物和眼内糖皮质激素缓释剂疗效显著,但后者需审慎使用以避免引发高眼压青光眼和加速白内障形成等问题。对于缺血型RVO,共识界定了其概念,明确了合并黄斑水肿时的治疗时间点,并阐明了激光治疗的适用条件。

Retinal vein occlusion(RVO)is a closely related disease of ophthalmology and systemic diseases.The Expert consensus on clinical diagnosis and treatment path of retinal vein occlusion in China(consensus)emphasizes that etiological diagnosis and treatment should be paid primary attention to,and etiological exploration should be placed in an important position in the diagnosis and treatment path.In addition to etiological treatment,the consensus emphasizes that clinical attention should be paid to the management of anterior segment neovascularization,neovascular glaucoma and macular edema.Especially for patients with short course of central retinal vein occlusion,the occurrence of 100-day glaucoma should be vigilant,and active anti-vascular endothelial growth factor(VEGF)drugs,laser photocoagulation and intraocular pressure treatment should be taken.For the treatment of macular edema,the consensus points out that anti-VEGF drugs and intraocular glucocorticoid sustained-release agents are effective,but the latter should be used cautiously to avoid problems such as high intraocular pressure glaucoma and accelerated cataract formation.For deficient RVO,the consensus defines its concept,defines the time point of treatment when combined with macular edema,and clarifies the applicable conditions of laser therapy.