非缺血型视网膜中央静脉阻塞的长期随访研究  

Long-term follow-up study of nonischemic central retinal vein occlusion

作　　者：卢宁[1] 王光璐[1] 张风[1] 彭晓燕[1] 

机构地区：[1]首都医科大学北京同仁眼科中心,100730

出　　处：《中华眼科杂志》2006年第6期488-491,共4页Chinese Journal of Ophthalmology

摘　　要：目的了解非缺血型视网膜中央静脉阻塞（CRVO）患者的临床特征、长期预后及发病相关因素.方法对随访3年以上的非缺血型CRVO患者进行回顾性分析,包括患者视力、眼底彩色图像及荧光素眼底血管造影资料.结果共35例（37只眼）非缺血型CRVO患者,随访时间3～15年,平均4.5年.男性14例（40%）,女性21例（60%）.末次随访,视力提高者仅2只眼（5%）,不变者11只眼（30%）,下降者24只眼（65%）;28只眼（75%）最终视力为0.1或以下;患者视力预后与初诊视力及年龄有关（P＜0.05）.9只眼（24%）转变成缺血型CRVO,其中5只眼继发新生血管性青光眼.黄斑部并发症：慢性黄斑囊样水肿13只眼,黄斑前膜3只眼,黄斑萎缩和黄斑区视网膜下增生膜各2只眼,黄斑裂孔1只眼;黄斑部并发症是视力预后差的主要原因.2例CRVO患者伴有原发性慢性闭角型青光眼和部分视神经萎缩,视力预后相对较好.结论CRVO严重损害患者视力,其主要原因为黄斑部的并发症.部分视神经萎缩对CRVO可能有保护作用.Objective To explore the clinical characteristic, visual prognosis and related factors of nonischemic central vein occlusion. Methods Retrospective data analysis （ including visual acuity, color fundus photography and fundus fluorescein angiography） was conducted in patients with nonischemic CRVO who were followed-up for 3 years or longer. Results The data of 35 cases （37 eyes） were analyzed. The follow-up time was 3-15 years, averaged 4.5 years. Age of those patients ranged from 18 to 76 years, averaged 56 years. Thirty cases （32 eyes） were over 40 years old. Two cases had chronic angle closure glaucoma. At the final visit, visual acuity improved in only 2 eyes （5%）, remained the same in 11 eyes （30%）, and decreased in 24 eyes （65%）. Twenty-eight eyes （75%） had a final visual acuity of 20/200 or less. Nine eyes （24%） transformed to the ischemic type, among which neovascular glaucoma occurred in 5 eyes. Macular complications were the major causes of serious visual impairment. The patients with chronic angle closure glaucoma and partial optic nerve atrophy had relatively good final visual acuity. Conclusions Nonischemic CRVO can Cause severe visual impairment. Macular complications are the major causes d vision loss. Partial optic nerve atrophy may have a protective effect on visual acuity in CRVO. （Chin J Ophthalmol , 2006,42 ： 488-491 ）

关 键 词：视网膜静脉闭塞 视觉 预后 随访研究 

分 类 号：R774.1[医药卫生—眼科]