特发性视网膜血管炎、动脉瘤、视神经视网膜炎综合征和Eales病荧光素眼底血管造影对比分析  

Comparative analysis of the characteristics of fundus fluorescein angiography of IRVAN syndrome and Eales disease

作　　者：史雪辉[1] 魏文斌[1] 杨丽红[1] 王光璐[1] 田蓓[1] 丁宁[1] 周丹[1] 王诏华[1] 

机构地区：[1]首都医科大学附属北京同仁医院、北京同仁眼科中心、北京市眼科学与视觉科学重点实验室,100730

出　　处：《中华眼底病杂志》2009年第2期119-123,共5页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察特发性视网膜血管炎、动脉瘤、视神经视网膜（IRVAN）综合征和Eales病荧光素眼底荧光血管造影（FFA）特征的异同。方法回顾分析IRVAN综合征患者4例8只眼和Eales病患者43例68只眼的FFA检查资料。所有患者均行常规眼科检查，包括视力、眼压、裂隙灯显微镜、间接检眼镜眼底检查。4例Eales病患者单眼玻璃体积血眼底窥不清，行对侧眼检查，其他所有患者双眼常规彩色眼底照相、共焦激光扫描FFA检查。IRVAN综合征4例8只眼，均为双眼发病。男性1例，女性3例；年龄16～43岁，平均年龄（27．00±12．93）岁。Eales病43例68只眼，男性32例，女性11例；年龄6～59岁，平均年龄（30．79士11．46）岁。双眼29例54只眼，单眼14例14只眼。两组患者眼底均可见视网膜血管白鞘或白线状改变、视网膜出血渗出、玻璃体积血。结果FFA检查结果显示，IRVAN综合征8只眼后极部动、静脉均受累；均可见多发性视网膜大动脉瘤。周边部毛细血管闭塞形成无灌注区7只眼，占87．50％；视盘水肿荧光渗漏5只眼，占62．50％；视神经萎缩2只眼，25．OO％；出血遮挡1只眼，占12．50％；视盘新生血管2只眼，占25．00％；视网膜新生血管4只眼，占50．00％；黄斑水肿4只眼，50．00％。Eales病43例68只眼中，所有患眼周边病变区视网膜静脉管壁渗漏；累及后极部静脉32只眼，占47．06％；动脉同时受累5只眼，占7．35％；周边部毛细血管闭塞形成无灌注区38只眼，占55．88％；视盘渗漏29只眼，占42．65％；视盘新生血管4只眼，占5．88％；视网膜新生血管26只眼，占38．24％；黄斑水肿15只眼，占22．06％。IRVAN综合征与Eales病患者在后极部动脉受累眼数、静脉受累眼数、动脉瘤眼数之间比较，差异有统计学意义（P均〈0．05）；视盘渗漏、无灌注区、视盘和视网膜新生血管、黄斑水肿眼数之�Objective To investigate the characteristics of fundus photography and fundus fluorescein angiography （FFA） of IRVAN （idiopathic retinal vasculitis, aneurysms, and neuroretinitis） syndrome and Eales disease. Methods The fundus photography and FFA data of 4 cases （8 eyes） with IRVAN syndrome and 43 cases （68 eyes） with Eales disease were retrospectively analyzed. All patients received ophthalmic routine examinations, including visual acuity, intraocular pressure, slit-lamp microscope and indirect ophthalmoscope. All patients had taken fundus photography and FFA for both eyes, except 4 patients of Eales disease who had vitreous hemorrhage in one eye. All 4 cases （1 male/3 female ）with IRVAN syndrome were bilateral and aged 16-43 years old（ mean age 27.00±12.93 years old）. 43 cases （32 male/ll female） of Eales disease aged 6-59 years old（ mean 30.79±11.46 years old）, 29 cases were bilateral and 14 cases were unilateral. Both diseases had retinal vascular white-sheath or white thread-like changes, exudative retinal hemorrhage and vitreous hemorrhage. Results Both arteries and veins of posterior pole of all eyes with IRVAN syndrome were involved and shown multiple retinal macroaneurysms. Other signs of IRVAN syndrome included capillary occlusion and non-perfusion （7/8 eyes, 87.5%）, fluorescein leakage and edema of optic disc （5/8 eyes, 62.5%）, optic atrophy（2/8 eyes, 25%）, vitreous hemorrhage（ 1/8 eyes, 12.5 % ）, neovascularization of optic disc （2/8 eyes, 25 % ）, retinal neovascularization （4/8 eyes, 50%） and maeular edema（4/8 eyes, 50%）. The signs of Eales disease included fluorescein leakage of peripheral retinal vein （68/68 eyes, 100%）, fluorescein leakage of posterior retinal vein （32/68 eyes, 47.06 %）, artery involvement （5/68 eyes, 7.35 %）, peripheral capillary occlusion and non-perfusion （38/68 eyes, 55.88 %）, fluorescein leakage of optic disc（29/68 eyes, 42.65%）, neovascularization of optic disc（4/68 eyes, 5.88 % ）, retinal

关 键 词：视网膜血管炎 动脉瘤 视网膜炎 荧光素血管造影术 疾病特征 

分 类 号：R774.11[医药卫生—眼科]