病程超过3d的视网膜动脉阻塞的治疗效果观察  

Clinical Observation of Patients with More than 3 Days Duration of Retinal Artery Occlusion

作　　者：朱修宇 董洋[1] 彭清[1] 

机构地区：[1]上海交通大学医学院附属新华医院眼科,上海200092

出　　处：《中国临床医学》2015年第6期741-745,共5页Chinese Journal of Clinical Medicine

基　　金：国家自然科学基金资助项目(编号:81470029)

摘　　要：目的：观察病程超过3 d的视网膜动脉阻塞（retinal artery occlusion,RAO）患者的治疗效果。方法：回顾分析2013年1月至2014年12月确诊RAO超过3 d的8例患者（8只眼）的临床资料。8例患者经眼底光学相干断层扫描（optical coherence tomography,OCT）和荧光素眼底血管造影（fundus fluorescein angiography,FFA）检查确诊后,立即进行扩容、扩血管、保护视神经等常规治疗,并局部和全身应用复方樟柳碱、丹参注射液等。随访1-12周,期间复查患者最佳矫正视力及OCT和FFA结果,并且对比分析患者治疗前后视力、视网膜水肿及眼底缺血情况。结果：8例患者治疗后视力均较治疗前好转,平均视力由0.18±0.15提高到0.65±0.34,差异有统计学意义（P〈0.01）。OCT显示,治疗后视网膜分支动脉阻塞区域视网膜水肿消失,视网膜厚度恢复正常;视网膜中央动脉阻塞经治疗后,后极部神经上皮层变薄萎缩。FFA显示,动脉阻塞区域视网膜血供全部或部分恢复正常。结论：病程超过3 d的RAO经积极有效的治疗后,仍有可能取得良好的疗效。Objective ：To observe the clinical effects of treatments on patients with more than 3 days duration of retinal artery occlusion （RAO） .Methods ：A total of 8 patients （8 eyes） with more than 3 days duration of RAO were retrospectively analyzed from January 2013 to December 2014 . All patients were diagnosed by medical examinations including optical coherence tomography （OCT ） and fundus fluorescein angiography （FFA） ,and after that they immediately received a series of routine treatments including vasodilator therapy ,volume expansion therapy and optic nerve protection medicine ,as well as Chinese traditional treatment such as compound anisodine and Danshen injection .All patients were followed up their best corrected visual acuity （BCVA） ,OCT ,and FFA from 1 to 12 weeks ,and compared the variations of their BCVA and retinal edema with their original situation .Results ：After receiving treatments ,the average BCVA of all patients was increased from 0 .18 ± 0 .15 to 0 .65± 0 .34 with a significant difference （P〈 0 .01） .OCT imaging showed that the edema in retinal artery occlusion area had vanished with partly neuroepithelium layer atrophied ,and FFA imaging also showed that blood supply had partly or totally returned to normal level .Conclusions ：Patients with more than 3 days duration RAO could also acquire a great clinical result after receiving active and efficient treatments .

关 键 词：视网膜动脉阻塞 治疗效果 最佳矫正视力 

分 类 号：R774.1[医药卫生—眼科]