视网膜大动脉瘤的临床特点及多波长氪离子激光治疗观察  

Clinical characteristics of retinal arterial macroaneurysms and efficacy of multi-wavelength krypton ion laser treatment

作　　者：季苏娟 张正培 李甦雁 JI Sujuan;ZHANG Zhengpei;LI Suyan(Department of Ophthalmology,The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University,Xuzhou First People′s Hospital,Xuzhou Institute of Ophthalmology Prevention and Control,Xuzhou 221002,China)

机构地区：[1]徐州医科大学附属徐州市立医院眼科,徐州市第一人民医院眼科,徐州市眼病防治研究所,徐州221002

出　　处：《中国眼耳鼻喉科杂志》2020年第5期386-388,共3页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的观察视网膜大动脉瘤(RAM)的临床特点及激光治疗效果。方法回顾分析2015年1月~2018年12月在我院激光治疗的23例(23眼)RAM患者的临床资料。分析眼底彩照、荧光血管造影及激光治疗效果。结果23例患者年龄33~86岁,平均(63.39±13.22)岁,<50岁4例(17.39%),>50岁19例(82.61%)。合并高血压病的患者16例(69.57%)。男性∶女性为8∶15。均为单眼发病。22例颞侧发病,其中15例为颞上方,7例为颞下方;1例鼻上方发病。22例为单发,1例为2个瘤体。视力:指数~0.6。对所有患者进行多波长氪离子激光治疗后3~6个月随访视力、眼底彩照,并复查荧光眼底血管造影,发现所有患者动脉瘤体均完全或部分萎缩、闭塞,渗出、出血逐渐吸收,视力提高18例、不变5例,无视力下降者,未出现瘤体破裂等并发症。激光治疗前后最佳矫正视力(BCVA)(LogMAR视力)分别为0.54±0.11、0.39±0.08,治疗后较治疗前有明显提高,差异有统计学意义(P<0.05)。结论RAM好发于老年女性,绝大多数单眼发病,多数为单发病灶,临床特点明确,荧光血管造影可明确诊断并进行随访。多波长氪离子激光治疗RAM安全有效。Objective To observe the clinical characteristics of retinal arterial macroaneurysms and the efficacy of laser treatment.Methods The clinical data of 23 patients(23 eyes)with retinal arterial macroaneurysms treated by krypton laser in our hospital from January 2015 to December 2018 were retrospectively analyzed.We summarized the patient′s medical history and analyzed the efficacy of fundus color photography,fluorescence angiography and laser therapy.Results The average age of 23 patients ranged from 33 to 86 years,with an average age of 63.39±13.22 years.Four patients(17.39%)were aged under 50 years of age and 19 patients(82.61%)were aged over 50 years of age.Sixteen patients(69.57%)had hypertension.The ratio of male∶female was 8∶15.All patients had unilateral ocular involvement.The lesions were on the temporal side of the retina in 22 patients,and on the upper nasal in one case including 15 cases of upper temporal,7 cases of lower temporal.Baseline visual acuity ranged from counting fingers to 0.6.All patients were followed up for 3 to 6 months after treatment with multi-wavelength krypton laser.Fluorescent fundus angiography showed that the aneurysms of 23 patients were atrophied or occluded completely or partially,exudation and bleeding were gradually absorbed.Visual acuity was improved in 18 cases,remained unchanged in 5 cases,no visual impairment was found.No complications such as aneurysm rupture appeared.Best-corrected visual acuity(BCVA,LogMAR visual acuity)before and after laser treatment were 0.54±0.11 and 0.39±0.08,which was significantly improved.Conclusions The retinal arterial macroaneurysms tends to occur in older women unilaterally.Fluorescein angiography can be used to confirm the diagnosis and follow-up.Multiwavelength krypton laser is a safe and effective in the treatment of retinal aneurysms.

关 键 词：视网膜大动脉瘤 荧光血管造影 临床特点 多波长氪离子激光 

分 类 号：R779.63[医药卫生—眼科]