视网膜大动脉瘤的多模式影像学特征及并发症观察  

Clinical observation of multimodal imaging characteristics and complications of retinal arterial macroaneurysms

作　　者：尹小芳[1] 叶祖科[1] 李国波[1] 汤秀容[1] 梁影影 黎彦豪 罗书科[1] 卢彦[1] YIN Xiaofang;YE Zuke;LI Guobo;TANG Xiurong;LIANG Yingying;LI Yanhao;LUO Shuke;LU Yan(Institute of Ophthalmology,the Second People’s Hospital of Foshan,Foshan 528000,Guangdong Province,China)

机构地区：[1]佛山市第二人民医院眼科研究所,广东省佛山市528000

出　　处：《眼科新进展》2020年第4期348-352,共5页Recent Advances in Ophthalmology

基　　金：佛山市医学科研项目(编号20190116);广东省中医药局科研立项课题(编号20162134);佛山市科技计划项目(编号2016AB001731);佛山市国家卫计委级医学重点专科培育项目(编号Fspy1-2015005)。

摘　　要：目的观察视网膜大动脉瘤的多模式影像学特征及并发症。方法回顾性分析2014年1月至2018年11月在我院确诊为视网膜大动脉瘤的临床病例资料。所有患者均行常规的眼部检查和眼底影像学检查,包括眼底彩照、频域光学相干断层扫描(spectral-domain optical coherence tomography,SD-OCT)、荧光素眼底血管造影(fundus fluorescein angiography,FFA)和(或)吲哚菁绿血管造影(indocyanine green angiography,ICGA)检查。分析其眼底影像学特征,观察并发症情况。结果39例患者纳入本研究,均为单眼发病。男7例(17.95%),女32例(82.05%),年龄53~86(71.33±9.06)岁。有高血压病史者30例(76.92%)。除1例为双瘤体外,其余均为单瘤体。所有患者均完成了眼底彩色照相和SD-OCT检查,38例完成FFA检查,8例完成ICGA检查。各项检查发现大动脉瘤体的情况眼底彩色照相32例(82.05%),SD-OCT检查31例(79.49%),FFA检查32例(84.21%),ICGA检查8例(100.00%)。39例患者中,9例并发了不同程度的玻璃体积血,1例并发视网膜分支动脉阻塞,1例并发视网膜分支动脉阻塞和分支静脉阻塞。结论眼底彩色照相、SD-OCT检查联合FFA检查可对大部分视网膜大动脉瘤进行明确诊断,ICGA检查可作为一项重要的补充检查手段。视网膜大动脉瘤可合并视网膜分支动脉或分支静脉阻塞,应引起临床重视。Objective To invetigate the multimodal imaging characteristics and complications of retinal arterial macroaneurysms(RAM).Methods Retrospective analysis was taken on clinical data of patients diagnosed with RAM in our department from January 2014 to November 2018.All patients underwent routine eye examination and fundus imaging,including fundus color imaging,spectral-domain optical coherence tomography(SD-OCT),fundus fluorescein angiography(FFA)and/or indocyanine green angiography(ICGA).The fundus imaging features were analyzed and complications were observed.Results Totally 39 patients with unilateral morbidity were enrolled in this study,including 7 males(17.95%)and 32 females(82.05%),aged from 53~86(71.33±9.06)years.There were 30 patient(76.92%)having history of hypertension.All patients suffered from single lesion of RAM except one patient,who had two lesions of RAM.All patients underwent fundus color imaging and SD-OCT,38 patients underwent FFA and 8 patients underwent ICGA examination.The findings of RAM from each examination were as follows 32 eyes in fundus color imaging(82.05%),31 eyes in SD-OCT(79.49%),32 eyes in FFA(84.21%),and 8 eyes in ICGA(100.0%).Among 39 patients,9 patients were complicated with different degrees of vitreous hemorrhage,one with branch retinal artery occlusion(BRAO),and one with both BRAO and branch retinal vein occlusion(BRVO).Conclusion Most RAM can be clearly diagnosed by fundus color photography,SD-OCT and FFA.ICGA is an important supplementary examination.RAM can be complicated with BRAO or BRVO that more attention should be paid to its diagnosis and treatment.

关 键 词：视网膜大动脉瘤 光学相干断层扫描 荧光素眼底血管造影 吲哚菁绿血管造影 

分 类 号：R774.1[医药卫生—眼科]