糖尿病视网膜病变玻璃体切除术后视网膜中央动脉阻塞表现及预后  

The clinical manifestation and prognosis in central retinal artery occlusion with diabetic retinopathy after vitrectomy

作　　者：赵霞[1] 陈芳[1] 董明霞[1] 高笙 

机构地区：[1]唐山市眼科医院,063000

出　　处：《中国实用眼科杂志》2015年第5期544-546,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察糖尿病性视网膜病变玻璃体切除术后视网膜中央动脉阻塞的临床表现及预后。方法收集2012年6月至2014年3月在唐山市眼科医院视网膜中央动脉阻塞（CRAO）患者10例（10只眼），所有患者均有糖尿病性视网膜病变玻璃体切除术病史；观察视力、眼压、眼前节及眼底的表现，并进行眼底荧光血管造影（FFA）及光学相关断层扫描（OCT）检查；所有患者均给予常规抢救治疗。结果10例患者均表现为视力突然明显下降；10例患者均出现视网膜动脉显著狭窄；5例部分血管闭塞；2例表现为典型的CRAO眼底改变（后极部视网膜灰白水肿，黄斑区樱桃红色）。FFA检查：提示所有患者视网膜中央动脉无灌注或充盈迟缓；OCT图像表现为8例黄斑区视网膜厚度增加，光感受器暗区增宽，其中4例合并黄斑囊样水肿，2例黄斑萎缩变薄。9例患者在20天内出现新生血管性青光眼。结论糖尿病性视网膜病变玻璃体切除术后出现的视网膜中央动脉阻塞的临床表现不典型，FFA是诊断的金标准；常规抢救治疗无效，预后极差。Objective To observe diabetic retinopathy central retinal artery occlusion after vitrec- tomy of clinical manifestation and prognosis. Methods Collected 10 patients with central retinal ar- tery occlusion （10 eyes）, and all patients had a history of diabetic retinopathy vitrectomy. The per- formance of vision, intraocular pressure, and the front section and fundus were observed. Also, the fundus fluorescence angiography （FFA） and optical coherence tomography （OCT） were commenced af- terward. All patients were given conventional rescue treatment. Result All of the 10 patients exhibit- ed an abrupt apparent drop of vision. Moreover, 10 cases of patients all revealed retinal artery steno- sis, with 5 cases of vascular occlusion. Furthermore, 2 cases of patients performed typical fundus changes （the deepest part of rear retina exhibited gray colored edema and the muscular area presented cherry red）. FFA examination： intimate all patients when central retinal artery suffer perfusion or de- layed filling. OCT image： 8 cases of retinal thickness increase, the photoreceptor dark zone broaden- ing, including 4 cases of merger macular edema capsule sample, 2 cases of macular atrophy thinning; 9 cases of patients with neo-vascular glaucoma in 20 days. Conclusions Diabetic retinopathy of cen- tral retinal artery occlusion after vitrectomy is atypical according to clinical manifestations, and FFA is the ideal standard of diagnosis; Conventional salvage treatment is invalid, the prognosis is poor.

关 键 词：糖尿病性视网膜病变 玻璃体切除术 视网膜中央动脉阻塞 临床表现 预后 

分 类 号：R774.1[医药卫生—眼科]