视网膜大动脉瘤的临床特点  

Clinical manifestations of retinal artery macroaneurysms

作　　者：王涛[2] 张惠蓉[1] 鹿新荣[1] 钱芳[1] 

机构地区：[1]北京大学第三医院眼科北京大学眼科中心,100083 [2]山东省日照市人民医院眼科,276800

出　　处：《中华眼科杂志》2008年第6期521-524,共4页Chinese Journal of Ophthalmology

摘　　要：目的观察视网膜大动脉瘤患者的临床特点并与其他眼底疾病相鉴别，以提高诊断的准确性。方法回顾性系列病例研究。回顾性分析22例（22只眼）确诊为视网膜大动脉瘤患者的临床资料。患者均行荧光素眼底血管造影和吲哚青绿血管造影检查，部分结合相干光断层扫描、B超等检查。结果22例患者中男性6例，女性16例；年龄54～82岁，平均70岁。均为单眼发病，22例中单个大动脉瘤19例，有2个大动脉瘤者3例；瘤体均位于颞侧动脉分支，其中颞上支16只眼，颞下支6只眼；动脉瘤全部位于1～3级分支内；所有患者均有不同程度的视网膜前出血和（或）玻璃体积血；最佳矫正视力〈0．05者10例，0．05～0．2者6例，0．3—0．6者5例，〉10．7者1例。所有患者均有不同程度的视网膜动脉硬化，16例患者有高血压病史，5例合并糖尿病史。治疗后追踪11例患者，最佳矫正视力〈0．05者1例，0．05～0．2者4例，〉10．7者6例。结论视网膜大动脉瘤多发生于老年人，特别是女性。常发生在视网膜动脉第1～3分支，局部扩张如瘤样，并有视网膜出血、水肿和渗出，同时多伴有视网膜动脉硬化。这些特点可与年龄相关性黄斑变性、Coats病及脉络膜新生血管等眼底病变相鉴别。Objective To summarize the clinical characteristics of retinal arterial macroaneurysm and to improve the diagnosis accuracy in order to differentiate it from other fundus diseases. Methods It was a retrospective case series. Results of fluorescein angiography or indocyane angiography, associated with ultrasound, OCT and several other examinations were analyzed in 22 patients （22 eyes） with retinal arterial macroaneurysm. Results There were 6 men and 16 women in the 22 patients. The age of all the patients was from 54 to 82 years, and the mean age was 70 years. In the 22 patients, the patient with a single macroaneurysm was 19, and with two macroaneurysms was 3. All 22 patients were affected unilaterally. Macroaneurysms were found only in the temporal artery hranches （ 16 eyes in superior hranch and 6 eyes in inferior hranch）. All macroaneurysms were located in the hranches graded 1 to 3. All patients showed preretinal hemorrhage and/or vitreous hemorrhage. Sixteen patients suffered from hypertension and five patients had diabetes mellitus. The patient with hest corrected visual acuity 〈0. 05 was 10,0.05 to 0. 2 was 6,0. 3 to 0. 6 was 5 and 〉10. 7 was 1. All patients showed retinal arteriosclerosis. After the treatment, 11 patients were pursued, and the patient with hest corrected visual acuity 〈 0. 05 was 1,0. 05 to 0. 2 was 4 and 〉10. 7 was 1. Conclusions Clinical features of retinal arterial macroaneurysm include focal dilation of retinal artery with hemorrhages and exudates,associated with retinal arteriosclerosis. These clinical characteristics can he used to differentiate retinal arterial macroaneurysm from other fundus diseases.

关 键 词：视网膜动脉 大动脉瘤 视力 低 

分 类 号：R686[医药卫生—骨科学]