家族性渗出性玻璃体视网膜病变的彩色多普勒血流显像特征分析  

Analysis of color Doppler flow imaging features of familial exudative vitreoretinopathy

作　　者：王子杨 杨文利 李逸凡 李栋军 陈伟 曹鑫杨 安洋 原铭贞 卢海 Wang Ziyang;Yang Wenli;Li Yifan;Li Dongjun;Chen Wei;Cao Xinyang;An Yang;Yuan Mingzhen;Lu Hai(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Ophthalmology&Visual Sciences Key Laboratory,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院,北京同仁眼科中心,眼科学与视觉科学北京市重点实验室,北京100730

出　　处：《中华眼底病杂志》2025年第2期126-132,共7页Chinese Journal of Ocular Fundus Diseases

基　　金：国家重点研发计划项目(2018YFC0116000)。

摘　　要：目的观察不同分期家族性渗出性玻璃体视网膜病变(FEVR)患眼的彩色多普勒血流显像(CDFI)特征。方法回顾性临床研究。2018年至2022年于北京同仁医院眼科住院并经眼底检查确诊的FEVR患者104例201只眼纳入研究。其中,男性69例133只眼,女性35例68只眼;年龄2个月~11岁,平均年龄2.9岁。患者双眼均行眼底、CDFI检查;同时行荧光素眼底血管造影检查72例144只眼。FEVR分期参照文献标准进行。1期:视网膜周边存在无血管区,或伴有视网膜异常新生血管;2期:视网膜周边无灌注区可见位于玻璃体视网膜交界面的视网膜新生血管;3期:未累及黄斑的部分视网膜脱离;4期:累及黄斑的部分视网膜脱离;5期:全视网膜脱离。观察不同分期FEVR患眼的CDFI影像特征。结果104例患者中,双眼、单眼发病分别为97(93.3%,97/104)、7(6.7%,7/104)例。201只眼中,FEVR分期1~5期分别为49(24.4%,49/201)、23(11.4%,23/201)、39(19.4%,39/201)、71(35.3%,71/201)、19(9.5%,19/201)只眼。CDFI检查,1期49只眼玻璃体未见异常或玻璃体轻度混浊;2期23只眼均出现玻璃体混浊,颞侧眼球壁回声不光滑;3期39只眼中,颞侧周边眼球壁前团条状回声17只眼,部分视网膜脱离13只眼;4期71只眼中,颞侧或颞下方视网膜皱襞51只眼,颞侧视网膜脱离20只眼;5期19只眼均为全视网膜脱离,其中视网膜脱离呈闭合“漏斗状”15只眼。视网膜皱襞51只眼中,双眼13例26只眼;单眼25例25只眼,其对侧眼均有不同程度玻璃体混浊或颞侧眼球壁前团条状回声;叠加多普勒后视网膜皱襞上均能探及血流信号。结论不同分期FEVR患眼的CDFI表现各有特征。当出现双眼颞侧或颞下视网膜皱襞,以及单眼视网膜皱襞、对侧眼玻璃体混浊或出现颞侧周边眼球壁前团条状回声时,需考虑FEVR的可能性。Objective To analyze the color Doppler flow imaging(CDFI)features of familial exudative vitreoretinopathy(FEVR)at different stages.Methods A retrospective study.A total of 104 patients with 201 eyes from Department of Ophthalmology of Beijing Tongren Hospital who were hospitalized for fundus examination and diagnosed with FEVR from 2018 to 2022 were included.There were 69 male cases with 133 eyes and 35 female cases with 68 eyes.The age was ranged from 2 months to 11 years,with a mean age of 2.9 years.Fundus and CDFI examination were performed in both eyes.Fluorescein fundus angiography was performed in 72 cases(144 eyes).FEVR staging was conducted according to literature standards.The presence of avascular areas in the peripheral retina or abnormal retina neovascularization was stage 1;the presence of retinal neovascularization at the vitreoretinal interface in the avascular area was stage 2;partial retinal detachment without macula involvement was stage 3;partial retinal detachment involving the macula was stage 4;complete retinal detachment was stage 5.The CDFI ultrasound features of FEVR at different stages were analyzed.The CDFI image features of FEVR patients in different stages were observed.Results Among the 104 patients,97(93.3%,97/104)cases were binocular and 7(6.7%,7/104)cases were monocular.In 201 eyes,stages 1 to 5 of FEVR were 49(24.4%,49/201),23(11.4%,23/201),39(19.4%,39/201),71(35.3%,71/201),and 19(9.5%,19/201)eyes,respectively.CDFI examination showed no abnormality or mild vitreous opacity in 49 eyes vitreous body at stage 1.Vitreous opacities were observed in all 23 eyes in stage 2,and the echo of the temporal ballwall was not smooth.In 39 eyes at stage 3,the anterior globular cluster echo in temporal peripheral eyes was observed in 17 eyes and partial retinal detachment was observed in 13 eyes.In 71 eyes at stage 4,51 eyes had temporal or infratemporal retinal folds,and 20 eyes had temporal retinal detachment.All the 19 eyes in stage 5 had total retinal detachment,of which 15 eyes had closed"fu

关 键 词：家族性渗出性玻璃体视网膜病变 彩色多普勒超声检查 视网膜皱襞 

分 类 号：R774.1[医药卫生—眼科]