眼部缺血综合征临床观察  

Clinical application of cell transplantation in ophthalmology

作　　者：张薇[1] 牛改玲[1] 张英华[1] 孙心铨[2] 刘颖[1] 

机构地区：[1]首都医科大学附属北京朝阳医院眼科,100020 [2]中日友好医院眼科

出　　处：《眼科》2005年第4期249-253,共5页Ophthalmology in China

摘　　要：目的探讨眼部缺血综合征(ocularischemicsyndrome,OIS)的临床表现及分期。设计回顾性病例系列研究。研究对象OIS患者13例16眼。方法患者行常规眼部检查、眼底荧光素血管造影(fundusfluorescentangiography,FFA)、眼动脉、颈动脉系统超声多普勒(dopplerultrasonography,DU)检查。主要指标视力,颈动脉狭窄程度,眼前节、眼底的临床体征及FFA结果。结果13例16眼均表现不同程度的视力下降。4眼有眼前段缺血表现。眼底检查显示16眼(100%)的视网膜动脉狭窄、平直,静脉纡曲扩张;视网膜小片状出血14眼(88%);棉絮斑3眼(19%);黄斑水肿12眼(80%);晚期视乳头新生血管形成3眼(19%)。FFA显示脉络膜血管充盈迟缓9眼(56%);视网膜血管循环时均延长16眼(100%);视网膜周边毛细血管无灌注11眼(73%)。DU均显示颈动脉狭窄或血流迟缓,管腔狭窄超过直径60%者4例(25%)。眼动脉血流流速减低11眼(69%)。根据FFA和颈动脉DU结果将该病分为早期与晚期。结论OIS是严重脑血管病与缺血性心脏病可以看到的眼部表现。FFA及眼动脉、颈动脉超声多普勒检查是诊断该病的重要手段。Objective To study the clinic features and stage of ocular ischemic syndrome （OIS）. Design Retrospective, observational case series. Participants 13 patients （ 16 eyes） with OIS. Methods Patients were performed by routine ophthalmologic examinations,fundus fluorescent angiographies （FFA）. Doppler ultrasonography （DU） was used to check carotid artery, ophthalmic artery and ciliary artery in all patients. Main Outcome Measures Vision acuity, degree of carotid artery stenosis, features of the anterior segment and fundus, FFA images. Results Visual acuity of 16 eyes was deteriorated variously. Corneal epithelia edema, aqueous flare and rubiorisis were found in 4 eyes. Fundus examination showed narrow-straight retinal arteries and dilated veins in 16 eyes （100 % ）. Scattered fleck-shaped hemorrhage was found in 14 eyes （88 % ）, cotton-wool spots in 3 eyes （19 % ）, macular edema in 12 eyes （80%）. Optic disc neovascularization appeared in 3 eyes （ 19% ） with advanced stage. FFA demonstrated chroidal blood flow delayed in 9 eyes （56 % ）, central retinal vessel circulating time elongated in 16 eyes （100 % ）, nonperfusion area appeared in the peripheral fundus in 11 eyes （73 % ）. DU showed stenosis of internal carotid artery or blood flow delayed in all patients, the degree of carotid artery stenosis more than 60 % of artery diameter was found in 4 patients（25 % ）. Blood flow of ophthalmic artery delayed was found in 11 eyes （69%）.According to FFA and DU images,OIS was classified as early and advanced stages. Conclusions OIS may be the presenting sign of serious cerebrovascular and ischemic heart diseases. FFA and DU of ophthalmic artery and carotid artery are important examinations for diagnosis of OIS.

关 键 词：眼部缺血综合征/诊断 眼底荧光素血管造影术 超声多普勒 

分 类 号：R771.3[医药卫生—眼科] R774[医药卫生—临床医学]