Purtscher样视网膜病变的临床观察  

Clinical observation of Purtscher-like retinopathy

作　　者：王波[1] 张玉洁[1] 靳睿 杨耀娟 华佳佳 常红敏 李传宝[1] WANG Bo;ZHANG Yujie;JIN Rui;YANG Yaojuan;HUA Jiajia;CHANG Hongmin;LI Chuanbao(Affiliated Hospital of Jining Medical University,Jining 272029,China)

机构地区：[1]济宁医学院附属医院,济宁272029

出　　处：《眼科学报》2023年第5期387-393,共7页Eye Science

基　　金：山东省自然科学基金(ZR2020QH149);济宁医学院教师科研扶持基金项目(JYFC2019FKJ112)~~。

摘　　要：Purtscher样视网膜病变是一种少见的视网膜血管性疾病,该文分析了13例Purtscher样视网膜病变的临床特征。典型的眼底表现包括Purtscher斑22眼、棉絮斑22眼、视网膜出血13眼、黄斑水肿22眼、视盘水肿12眼和假樱桃红斑10眼。荧光素血管造影异常表现包括毛细血管无灌注区21眼,毛细血管前闭塞22眼。13例患者中有9例使用糖皮质激素、免疫抑制剂,4例使用改善循环、营养神经等治疗。随访2月至5年,4例患者(6眼)在随访期间出现神经上皮萎缩并持续低矫正视力(<0.1)。基于文献回顾,讨论了Purtscher样视网膜视力恢复不佳可能与黄斑水肿及无灌注区形成有关。Purtscher-like retinopathy is a rare retinal vascular disease.In this study,the clinical characteristics of 13 cases of Purtscher-like retinopathy were analyzed.Typical fundus abnormalities included Purtscher flecken(22 eyes),cotton-wool spots (22 eyes), retinal hemorrhages (13 eyes), macular edema (22 eyes), swelling of optic disk (12 eyes), and falsecherry red spots (10 eyes). The abnomal manifestations of fluorescein angiography included non-perfusion area of capillaries (21 eyes), and precapillary occlusion (22 eyes). Among 13 patients, 9 patients were treated with glucocorticoids and immunosuppressive drugs, and 4 patients were treated with circulation-improving and neurotrophic drugs. During the follow-up period of two months to five years, four patients (six eyes) experienced neuroepithelial atrophy and persistent low vision (<0.1). Based on literature review, we proposed that the prognosis of vision in Purtscher-like retinopathy may be associated with macular edema and the formation of capillary non-perfusion.

关 键 词：Purtscher样视网膜病变 Purtscher斑 棉绒斑 黄斑水肿 毛细血管无灌注区 

分 类 号：R774.1[医药卫生—眼科]