视网膜中央静脉阻塞的临床特点及诊断和治疗(附1例报告)  

Clinical characteristics,diagnosis and treatment of central retinal vein occlusion in patients(a case report)

作　　者：胡艳滨[1] 高军[2] 高惠娟 HU Yanbin;GAO Jun;GAO Huijuan(Branch of Tianjin Third Central Hospital,Tianjin 300250,China;不详)

机构地区：[1]天津市第三中心医院分院,天津300250 [2]天津市第三中心医院

出　　处：《山东医药》2020年第36期33-37,共5页Shandong Medical Journal

摘　　要：目的总结视网膜中央静脉阻塞(CRVO)的临床特点、诊断方法和治疗方法。方法回顾性分析1例中青年CRVO患者的临床资料。结果患者因“右眼前闪光感,可见条纹样黑影1周”就诊;双眼矫正视力1.0;眼底照相显示右眼视盘充血、边界模糊不清,视网膜静脉迂曲扩张明显,局部呈腊肠样改变,视网膜散在点片状出血,黄斑区无水肿。眼底荧光血管造影(FFA)检查符合“右眼CRVO、右眼视盘水肿”,进而诊断为CRVO。给予口服及球旁注射激素治疗,辅以活血化瘀、改善微循环、营养神经药物,治疗后复查眼底照相以及光学相干断层扫描血管成像(OCTA)检查显示视盘上、下方侧支血管逐渐形成,侧支血管形成初期较为细小,后逐渐增粗、走形较为迂曲,并呈单支走形,尤其下方侧支呈现多圈状,伴随侧支血管的出现,视网膜静脉迂曲扩张状态以及视盘水肿逐渐缓解,并完全恢复,病程进展中未出现黄斑水肿,视力无下降,闪光感逐渐恢复,条纹样黑影消失,随访11个月无复发。结论CRVO的临床特点为视盘充血、边界模糊不清,视网膜静脉迂曲扩张明显,局部呈腊肠样改变,视网膜散在点片状出血,黄斑区无水肿;眼底照相、FFA检查可以确诊;口服及球旁激素注射治疗后视盘侧支血管逐渐形成,并在OCTA中呈像清晰,表现为走形迂曲的单根血管,可呈多圈状,患者预后良好。Objective To summarize the clinical characteristics,diagnosis and treatment of central retinal vein occlusion(CRVO)in patients.Methods The clinical data of one patient with CRVO were retrospectively analyzed.Results The patient visited the hospital because of“the flashing sensation in the right eye and the visible striated black shadow for 1 week”;the binocular corrected visual acuity was 1.0;fundus photography showed that the optic disc was hyperemic with blurred boundary in the right eye,retinal vein was tortuous and dilated obviously,locally similar to sausage,the retina had sporadic and patchy hemorrhage,and there was no edema in macular area.Fundus fluorescein angiography(FFA)examination was consistent with“right eye CRVO,right eye optic disc edema”and was subsequently diagnosed as CRVO.Oral and periocular injection of steroid hormone therapy was administered,supplemented by promoting blood circulation to remove blood stasis,improving microcirculation and neurotrophic treatment.After treatment,fundus photography and optical coherence tomography angiography(OCTA)were performed and showed that the collateral vessels gradually formed above and below the optic disc,the beginning of the collateral vessels formation was relatively small,then gradually ectatic,more tortuous and showed a single branch,especially the below collateral vessel of optic disc was loopy.Accompanied by the emergence of collateral vessels,the tortuosity and dilatation of central retinal veins and optic disc edema were gradually relieved and completely recovered,no macular edema occurred in the progression of the disease.Visual acuity was not decreased and the sense of flash was gradually restored,the black striated shadow was disappeared.No recurrence was found in the 11-month follow-up.Conclusions The clinical characteristics of CRVO are as follows:the optic disc is hyperemic,the boundary is blurred,the retinal vein is tortuously dilated,the local changes are similar to sausage,the retinal hemorrhage is scattered in the patchy,and t

关 键 词：视网膜中央静脉阻塞 侧支血管 眼底照相 光学相干断层扫描血管成像 

分 类 号：R774.1[医药卫生—眼科]