复方血栓通对于视网膜分支静脉阻塞患者的眼底形态学影响

目的: 观察复方血栓通胶囊对于视网膜分支静脉阻塞患者的眼底形态学影响。方法: 选取视网膜分支静脉阻塞患者85例85眼随机分为两组,实验组患者43例接受复方血栓通胶囊治疗,对照组患者42例接受丹参治疗,对于两组患者治疗前后的眼底形态学改变进行对照研究。结果: 实验组患者的黄斑水肿消退率及治疗有效率显著高于对照组。两组患者治疗前的最佳矫正视力、视网膜静脉相对直径和视网膜出血相对面积均无显著差异,治疗后两组患者的最佳矫正视力均显著升高,但实验组好于对照组;两组患者治疗后的视网膜静脉相对直径和视网膜出血相对面积均较治疗前显著降低或缩小,实验组治疗后的视网膜出血相对面积显著小于对照组。结论: 复方血栓通胶囊可以有效促进视网膜分支静脉阻塞患者的视力恢复和视网膜出血面积缩小,效果优于丹参治疗。     

复方血栓通胶囊对视网膜分支静脉阻塞病灶微循环的影响

目的 评价复方血栓通胶囊治疗视网膜分支静脉阻塞的临床效果及其对病变区视网膜微循环的影响。 设计 临床对照研究。研究对象 连续收集自然病程为3~6个月的视网膜分支静脉阻塞患者90例,随机分为复方血栓通治疗组和对照组各45例。方法 治疗组患者接受复方血栓通胶囊1.5 g 每日3次和卵磷脂络合碘1.5 mg 每日3次;对照组接受曲克芦丁120 mg 每日3次和卵磷脂络合碘1.5 mg 每日3次。所有患者连续观察6个月,每3个月复查一次荧光素眼底血管造影,定性描述病变区毛细血管无灌注区（NPA）及侧枝循环的形成情况。当患者NPA >5 PD时给予病变区激光光凝。 主要指标 患者激光治疗率（NPA形成率）,侧枝循环形成率。 结果 观察期内,治疗组中31例（68.89%）因FFA显示NPA>5 PD或发现视网膜新生血管而接受激光治疗,对照组中33人（73.33%）接受激光治疗,两组间激光治疗率差异无统计学意义（P=0.816）。至随访期结束,治疗组中34例（75.56%）FFA显示侧枝循环建立,而对照组中24例（53.33%）FFA显示侧枝循环建立,两组间侧枝循环形成率差异具有统计学意义（P=0.047）。结论 复方血栓通胶囊有助于视网膜分支静脉阻塞病灶视网膜血管与正常视网膜血管间建立侧枝循环。     

复方血栓通胶囊治疗视网膜静脉阻塞的效果观察

目的：观察复方血栓通胶囊治疗视网膜静脉阻塞的临床疗效。方法：对39例已确诊为视网膜静脉阻塞的患者给予口服复方血栓通胶囊3粒/次,3次/d,服用30～90d。根据视力恢复情况、视网膜出血吸收、黄斑水肿吸收情况等眼底变化以及自觉症状有无改善进行观察。结果：患者39例中：显效12例（31%）、有效21例（54%）、无效6例（15%）,总有效33例（85%）。治疗中未发现毒副作用。结论：复方血栓通胶囊是治疗视网膜静脉阻塞安全有效的药物。     

激光联合复方血栓通胶囊治疗视网膜静脉阻塞的临床观察

目的：观察激光联合复方血栓通胶囊治疗视网膜静脉阻塞的临床疗效。

方法：将64例视网膜静脉阻塞患者随机分为激光治疗组(对照组,32例)和激光联合复方血栓通胶囊治疗组(观察组,32例),观察对比两组治疗后的视力、视网膜黄斑厚度和有效率。

结果：观察组临床总有效率和视力进步比例均显著高于对照组,两组间差异具有统计学意义(P<0.05或P<0.01); 两组治疗后1、3、6mo的黄斑中心凹厚度均较治疗前显著降低(P<0.05),但观察组治疗后1、3、6mo的黄斑中心凹厚度均明显小于对照组同期(P<0.05)。

结论：激光联合复方血栓通胶囊治疗视网膜静脉阻塞伴黄斑水肿有较好的疗效,能有效提高视力,降低视网膜黄斑厚度,值得进一步研究。     

激光光凝治疗对视网膜分支静脉阻塞和黄斑静脉阻塞视网膜血管直径的影响

目的：研究成功视网膜静脉阻塞光凝治疗对不同直径视网膜血管对光凝治疗的反应和作用。 方法：研究包括14例静脉分支阻塞或黄斑静脉阻塞患者。眼科检查包括最佳矫正视力、活体显微镜检查、眼底照相和荧光眼底血管造影。在激光治疗术前和术后，应用一种视网膜血管分析仪测量视网膜血管直径。     

川芎嗪联合血栓通治疗视网膜静脉阻塞

视网膜静脉阻塞 (RVO)是由多种因素诱发视网膜静脉血栓形成而引起的视网膜血管病 ,是致盲的重要眼病之一。我院自 1995年 3月～ 1999年 3月共收治 RVO31例 ,采用川芎嗪离子导入联合血栓通治疗 ,获得较好的疗效 ,现报告如下。一、临床资料1.一般资料 :本组 31例 31眼 ,男 19例 ,女 12例 ,年龄最小 31岁 ,最大 81岁 ,平均 5 9岁。右眼 14例 ,左眼 17例 ,病程最短 1天 ,最长 30天 ,31例中 ,中央静脉阻塞 5眼 ,分枝静脉阻塞 2 6眼 ,其中伴有高血压动脉硬化 2 0例 ,高血脂 5例 ,糖尿病 2例。2 .治疗方案 :川芎嗪直流电药流物离子导入 ,每日 1…     

氩激光联合血栓通治疗眼底静脉阻塞及糖尿病视网膜病变68例

目的探讨中老年患者的眼底静脉阻塞(静阻)及糖尿病视网膜病变(糖网)的有效治疗方法。方法根据病变的诊断标准进行分型，并作视力、视野、眼压、眼底镜及眼底荧光造影检查。本文的研究对象主要是中老年患者的静阻及糖网的渗出型。对病灶区有渗出、出血、血管瘤者先使用氩激光进行光凝治疗，同时静脉点滴血栓通针剂2个疗程，然后改为口服血栓通胶囊，6个月1个疗程，可坚持常年用药。结果对68例病例有效为59例(87％)，随访1～4年病情稳定54例(79％)。结论氩激光联合血栓通治疗静阻及糖网是一种较为理想和有效的方法。     

基于荧光眼底特征探讨视网膜分支静脉阻塞的临床分型

目的:分析视网膜分支静脉阻塞(branch retinal vein occlu-sion,BRVO)的荧光素眼底血管造影特征,探讨视网膜分支静脉阻塞进一步分型的必要性。方法:回顾荧光素眼底血管造影检查1450例BRVO患者,依荧光眼底像确定患者阻塞点位于动静脉交叉处2～3级以上者56例56眼,对其视网膜无灌注区大小,新生血管等情况进行观察。结果:患者56例56眼,占BRVO患者总眼数的3.9%,其中视网膜2级动静脉交叉阻塞者29眼,3级动静脉交叉阻塞者18眼,3级以上动静脉交叉阻塞者9眼。荧光视网膜像显示56眼中42眼存在阻塞所属区域小片无灌注区低荧光,16眼有新生血管性高荧光,未见玻璃体积血,增生性视网膜病变及牵拉性视网膜脱离等并发症发生。结论:临床视网膜动静脉交叉处2～3级以上BRVO者有别于常见的BRVO,其视网膜损害范围轻,出血范围小,程度轻,且无灌注区面积小,发生新生血管密度低,此类患者有必要单独列出,BRVO值得进一步分型,以促进临床的诊治。     

血栓通与血府逐瘀汤加减治疗视网膜静脉阻塞

视网膜静脉阻塞(RVO)是眼科较常见的视网膜血管病，发病急，病情重，治疗较棘手，预后常不良。笔者自1998年8月以来采用血栓通与血府逐瘀汤加减治疗本病32例，取得较好疗效，现报告如下。     

视网膜分支静脉阻塞的临床分析

目的 为了了解视网膜分支静脉阻塞患者的合并症发生的情况。 方法 回顾性地分析本院1995年10月到1999年10月277例（277只眼）视网膜分支静脉阻塞的病例。 结果 70%以上的病例发病年龄均在55岁以上，81.58%的分支静脉阻塞发生于颞上及颞下象限。分支静脉阻塞合并症的发生率与阻塞的位置密切相关，愈大的分支静脉阻塞，其无灌注区及新生血管的发生率也就愈高。 结论 视网膜分支静脉阻塞黄斑水肿发生在发病的早期，无灌注区的出现多在7～12个月，而新生血管的出现，多半在一年以后，因此对这些患者应当有更长期的追踪观察。 （中华眼底病杂志，2002，18：17-19）     

Long-term visual outcome of arteriovenous adventitial sheathotomy on branch retinal vein occlusion induced macular edema

PURPOSE: To evaluate long-term visual outcome of arteriovenous adventitial sheathotomy in BRVO-induced macular edema. METHODS: The visual outcomes of 8 patients following vitrectomy with arteriovenous adventitial sheathotomy for BVO-induced macular edema (surgery group) were retrospectively evaluated. The three-year post-operative visual acuity of the surgery group was compared with that of the conservatively managed controls. RESULTS: All patients were followed for a minimum of 36 months. Mean BCVA (logMAR) in the surgery group changed from 1.10+/-0.34 to 1.19+/-0.70 and to 0.80+/-0.36 at 12 and 36 months, respectively (p=0.959 at 12 months, p=0.018 at 36 months). In the control group, visual acuity improved from 1.15+/-0.43 to 0.43+/-0.44 and to 0.43+/-0.39 at 12 and 36 months, respectively (p=0.015 at 12 months, at p=0.003 at 36 months). A strong trend toward better visual acuity at 12 months and final examination was observed for controls. (surgery vs. control group, p=0.052 at 12 months, p=0.066 at 36 months). CONCLUSIONS: Considering the favorable natural course of BVO and the unproven effect of reperfusion on macular edema, surgical efficacy of arteriovenous adventitial sheathotomy requires further evaluation.     

Decreased inner retinal activity in branch retinal vein occlusion

The electroretinogram, electro-oculogram and electroretinogram oscillatory potential all reflect the mass activity of the retina. The electroretinogram usually remains normal after branch retinal vein occlusion, whereas the electro-oculogram and oscillatory potential often show abnormalities. These tests thus have a differential sensitivity to branch retinal vein occlusion. However, whether the inner layer of the retina is affected in branch retinal vein occlusion has not been determined. In this study, conventional electroretinographic and oscillatory potential data were compared in 34 patients with branch retinal vein occlusion, while electroretinographic and electro-oculographic data were compared in 30 patients with branch retinal vein occlusion, in an attempt to determine whether the inner retina was affected in this disorder. None of the conventional electroretinographic variables showed any significant difference between the eyes with branch retinal vein occlusion and the fellow eyes. In the oscillatory potential test, however, the sum of the amplitudes of O₁, O₂, O₃ and O₄ showed a significant difference (p < 0.02).=" in=" addition,=" the=" light=" peak-dark=" trough=" ratio=" and=" the=" light=" peak=" showed=" a=" significant=" difference=" in=" the=" electro-oculogram=" (p=">< 0.05=" and=" p=">< 0.05,=" respectively).=" since=" the=" oscillatory=" potential=" and=" the=" electro-oculogram=" light=" rise=" potential=" reflect=" the=" activity=" of=" the=" inner=" retina,=" our=" data=" suggest=" that=" the=" inner=" retina=" was=" affected=" by=" branch=" retinal=" vein=" occlusion=" and=" that=" these=" variables=" are=" more=" sensitive=" indicators=" than=" the=">     

氪红激光光凝治疗视网膜分支静脉阻塞临床疗效分析

目的　分析并比较氪红激光光凝治疗视网膜分支静脉阻塞的临床疗效。方法　 12 4例 12 4眼视网膜分支静脉阻塞患者 ,分别采用氪红 (6 4例 )、氪绿 (6 0例 )激光光凝治疗 ,术后定期观察视力、黄斑水肿及视网膜新生血管情况 ,随访时间 7.1± 3.4月。结果　氪红激光组中 :视力明显提高或提高者 5 3% ,不变者 34% ,下降者 13%(P <0 .0 0 1) ;黄斑水肿完全消退者 38% ,部分消退者 42 % ,不变者 2 0 % (P <0 .0 0 1) ;视网膜新生血管完全消退者6 7% ,部分消退者 33%。氪绿激光组中 :视力明显提高或提高者 6 3% ,不变得 2 3% ,下降者 13% (P <0 .0 0 1) ;黄斑水肿完全消退者 38% ,部分消退者 5 0 % ,不变者 12 % (P <0 .0 0 1) ;视网膜新生血管完全消退者 6 1% ,部分消退者39%。两组间的视力、黄斑水肿及视网膜新生血管变化无显著性差异 (P >0 .1)。结论　氪红、氪绿激光光凝对视网膜分支静脉阻塞都同样有效 ,但氪红激光主要适用于屈光间质混浊的患者。     

Evaluation of retinal functional loss in branch retinal vein occlusion

Purpose: Branch retinal vein occlusion (BRVO) induces variable functional deficits depending on the grade of vascular occlusion and its localisation. Theses deficiences are not easily defined by visual acuity measurements. However, microperimetry offers topical mapping of retinal function, allowing precise documentation of the intensity and dimension of retinal functional loss in BRVO. Methods: Retinal sensitivity was examined using a Rodenstock Scanning Laser Ophthalmoscope (SLO). A standardized grading system of stimuli ranging from 0 to 32 dB was used to document the retinal threshold in three different areas: regions presenting vascular occlusion, the collateral edematous zone and adjacent areas with intact perfusion. Absolute and relative scotomas as well as the fixation behavior were studied. Results: Forty-two patients with isolated BRVO within the vascular arcades were examined with microperimetry and angiography. At initial presentation with BRVO the retinal sensitivity in the area of occlusion on average diminished to 4.1 dB. In the collateral edematous zone retinal threshold was reduced to 21.5 dB; areas with intact perfusion demonstrated a threshold of 23.2 dB. Within the occluded area itself defects of significantly differing intensity were found which only partially correlated with the angiographic evidence. Intense scotomas (0 dB) were observed in 59 % of the eyes examined: angiographically nonperfused areas or extended intraretinal hemorrhage were present. Relative scotomas (12.1 dB) were seen in 19.1 % and minimal, non-significant defects (19.5 dB) were documented in 21.4 % of the BRVO. The level of angiographically documented leakage did not correlate with the functional deficits present in these two groups. Measurements performed after 6–8 weeks revealed noticeable spontaneous recovery of retinal sensitivity, unless an additional progressive closure occurred. The average functional improvement in the area of leakage found after laser therapy was less than the results shown in spontaneous resolution of edema. Conclusions: BRVO may lead to significant reductions of central and paracentral retinal function. Angiographically observed leakage is not always directly correlated to the magnitude of retinal sensitivity loss. As spontenous remission is frequent in one group and intact retinal function can be shown in areas of angiographic leakage, therapeutic interventions, e. g. laser treatment, should be carefully considered. Scanning laser ophthalmoscopy provides additional information for precise evaluation and follow-up of the retinal damage in BRVO.      

无早期症状的视网膜分支静脉阻塞临床特点

目的观察视网膜分支静脉阻塞(BRVO)中,因不参与引流黄斑区血液,而阻塞早期无症状病例的临床及荧光素眼底血管造影(FFA)特点。方法回顾性分析BRVO病例中因合并玻璃体积血就诊及FFA检查时偶然发现的66例(70只眼)临床资料。结果 66例BRVO病例中,右眼26例,左眼36例,双眼4例。颞上周边支阻塞45只眼,占68.18%;颞下周边支5只眼,占7.58%;鼻上支8只眼,占12.12%;鼻下支12只眼,占18.18%。FFA检查时偶然发现17例,占25.76%;继发玻璃体积血49例,占74.24%。70只眼均发现大小、数量不等的视网膜新生血管。伴增生膜5只眼,占7.58%。合并视盘新生血管3只眼,占4.55%。黄斑前膜4只眼,占6.06%;视网膜裂孔、并继发视网膜脱离6只眼,占8.57%。结论无早期症状BRVO病例,均为BRVO后期并发症,与其它类型BRVO有所不同。     

Disc hemorrhages in patients with both normal tension glaucoma and branch retinal vein occlusion in different eyes

PURPOSE: To document the clinical features of disc hemorrhage in patients with branch retinal vein occlusion (BRVO) and normal tension glaucoma (NTG), and to evaluate the relationship between BRVO and NTG with disc hemorrhages. METHODS: From July 2001 to May 2006, sixteen patients with both NTG and BRVO in different eyes were successively collected from outpatient population of Seoul National University Hospital in this observational case series. The frequency and location of disc hemorrhages, history of associated systemic diseases, and the order of the time of diagnosis between NTG and BRVO were studied. RESULTS: All patients had unilateral BRVO, and their mean age was 63.3+/-10.6 years. Disc hemorrhages were detected in eight patients (50%) during the mean follow-up of 26.8 months (range, 3-96 months). Six patients (75%) had disc hemorrhages in the non-BRVO eyes and two patients (25%) in BRVO eyes. Five hemorrhages (62.5%) were located at inferior-temporal quadrant of the optic disc. History of systemic hypertension was identified in 12 patients (75.0%). In 11 patients (68.8%), NTG was diagnosed at the same time as BRVO. CONCLUSIONS: A higher frequency of disc hemorrhages was identified in patients with both BRVO and NTG. Therefore, some cases of NTG, especially with disc hemorrhages, may share a common vascular pathophysiology with BRVO.     

Natural history of macular status in recent-onset branch retinal vein occlusion: an optical coherence tomography study

Purpose: To evaluate serially the course of structural changes in the macula in recent onset branch retinal vein occlusion (BRVO), using optical coherence tomography (OCT). Methods: Twenty eyes of patients at an institutional practice with recent onset BRVO were examined by OCT at presentation and at 3 and 6 months of onset of the occlusion. The macular thickness (MT) and the visual acuity were correlated with the macular perfusion status and analyzed statistically. Results: The mean MT at presentation, 3 and 6 months was 398.9 +/- 98.6 mm, 346.8 +/- 84.8 mm and 341.3 +/- 95.3 mm, respectively. Three distinct anatomical patterns of structural changes were appreciated on OCT-serous retinal detachment (SRD) only in 15%, cystoid macular edema (CME) only in 40%, and a combined form with both SRD and CME in 45%. At 6 months while the non-ischemic group showed an average percentage decline of 26.8% in thickness, the ischemic group showed an increase of 19.2% (P < 0.01). CME resolved in 10 of 13 perfused (non-ischemic) maculae, but persisted in all seven ischemic cases. Conclusion: OCT delineates macular changes at a stage when fundus biomicroscopy and fluorescein angiography are not very informative. The anatomical cause for the increase in MT i.e., SRD and/or CME is also well delineated. Non-ischemic maculae show an early and more rapid decline in MT compared with ischemic occlusions. An increase in MT at 3 months on OCT in BRVO patients could be an indication of a possible ischemic course.