视网分枝静脉阻塞发病的解剖学因素

为了评价动静脉交叉在视网膜分枝静脉阻塞（ＢＲＶＯ）发病中的作用，我们对５０名ＢＲＶＯ患者的ＦＦＡ负片进行了分析，并以同一患者的同一眼的对侧血管弓及对侧眼的相同象限的相应的动静脉交叉作为对照组。结果发现：本组ＢＲＯＶ患者有８０％发生在颞上象限，１６％发生在颞下象限，４％发生在鼻上象奶，且阻塞点均位于动静脉交叉处，而动静脉交叉动于静脉之前且交叉与视盘距离近是ＢＲＶＯ发病的解剖学方面的危险因素。     

视网膜中央静脉阻塞发病因素的病例对照观察

目的 观察视网膜中央静脉阻塞(CRVO)患者与主要的全身性疾病、眼局部疾病以及相关危险因素的关系。 方法 病例对照研究。患者组：76例病程在3个月内、经荧光素眼底血管造影(FFA)检查确诊、未进行过药物治疗的CRVO患者；对照组：76例非CRVO患者，既往无眼底血管性疾病史，以年龄和性别与患者组一对一相匹配。患者组按年龄分为≤45岁（25例，占32.9%）和＞45岁（51例，占67.1%）两个亚组；按FFA检查结果分为非缺血型（40例，占52.6%）和缺血型（36例，占47.4%）两个亚组。检测血脂、血压和空腹血糖等。各组之间分别进行全身性和眼局部性疾病以及相关危险因素的统计学比较。 结果 患者组高血压和高脂血症患病率明显高于对照组（P＜0.001，P=0.001），而心、脑血管疾病、开角型青光眼的发病率、以及吸烟和饮酒生活习性上差异无统计学意义（P＞0.05）。年龄≤45岁组中，患者组各项指标与对照组差异无统计学意义（P＞0.05）。缺血型CRVO组，除高血压和高脂血症外, 糖尿病发病率明显高于对照组（P＜0.001，P=0.031，P=0.024）。 结论 高血压和高脂血症为CRVO发病的全身性因素。此外，糖尿病与缺血型CRVO发病也相关。及时诊断和治疗全身性疾患对于CRVO的防治具有重要指导意义。 (中华眼底病杂志，2007，23：159-162)     

视网膜静脉阻塞的危险因素分析

目的 分析视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)和视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)的危险因素;并对CRVO和BRVO危险因素进行直接比较.方法 对46例CRVO(CRVO组)、33例BRVO(BRVO组)与79例老年性白内障或屈光不正患者(对照组)行危险因素和血脂谱分析,并对比观察.结果 多元线性回归分析结果显示:高同型半胱氨酸血症(P＜0.000 1)、高总胆固醇(P=0.003 0)、高脂蛋白a(P =0.027 0)、高血压(P =0.022 0)、短眼轴(P ＜0.000 1)与CRVO显著相关;而高同型半胱氨酸血症(P＜0.0001)、高总胆固醇(P =0.008 0)、高血压(P=0.002 0)、高体质量指数(P=0.004 0)、短眼轴(P=0.001 0)与BRVO相关.一元线性回归分析示CRVO和BRVO上述危险因素比较没有明显差别.结论 CRVO、BRVO危险因素包括系统(高血脂、高血压、高同型半胱氨酸)和眼部(短眼轴)的多种因素,但是这些危险因素在CRVO和BRVO之间没有显著差异.     

视网膜血管外膜切开术治疗视网膜分枝静脉阻塞

视网膜分枝静脉阻塞是临床上常见的视网膜血管性病变,其常见的并发症黄斑水肿和视网膜新生血管对患的视力威胁较大,最近一种新的治疗方法一扁平部玻璃体切除联合视网膜血管外膜切开术已显示出较好的临床疗效。本对该项手术技术及其临床疗效进行介绍和讨论。     

视网膜分枝静脉阻塞研究新进展

视网膜分枝静脉阻塞在临床上较常见,发病率在眼底疾病中仅次于糖尿病性视网膜病变,占第二位。目前对其发病机制。危险因素,分类方法等有不同看法。近年来,随着临床基础医学的迅速发展,人们对其病因和发病机制有了较深刻的理解,对其治疗提出了一些新观点,     

视网膜静脉阻塞的流行病学调查

视网膜静脉阻塞是常见的视网膜血管性疾病,是导致单眼视力损害的主要原因之一。视网膜静脉阻塞病因复杂,不同类型致病因素并不完全相同。与视网膜静脉阻塞相关的眼部危险因素包括眼解剖因素、眼压、青光眼、屈光状态和视网膜微血管病变等;全身危险因素包括年龄、高血压、心血管疾病、糖尿病和肥胖等。保护性因素包括少量饮酒、体力活动、妇女停经后补充雌激素和高水平高密度脂蛋白等。     

视网膜静脉阻塞的激光治疗

视网膜静脉阻塞是常见的致盲眼病，近年来国内外学者对激光在治疗中的应用进行了大量的研究，本文对其中的一些工作进行简要综述。     

视网膜分枝静脉阻塞的激光治疗时机探讨

目的:观察累及黄斑部视网膜分支静脉阻塞病人发病1～2个月进行早期激光治疗效果。方法:临床观察30例30眼累及黄斑部视网膜分支静脉阻塞病人进行早期氩激光视网膜光凝治疗的临床效果,并与30例30眼药物治疗组病人进行对比。结果:治疗后3个月复查,视力:治疗组,增进者27眼,无变化2眼,下降1眼;对照组,增进者18眼,无变化6眼,下降6眼。视网膜出血吸收情况;治疗组,Ⅱ度以上吸收者27眼（90.1％）,Ⅳ度吸收者4眼（13.3％）;对照组分别为15眼（50.0％）和1眼（3.3％）。黄斑水肿消退:治疗组26眼,对照组9眼。新生血管出现:对照组2眼,治疗组无新生血管出现。结论:对危及黄斑部视网膜分支静脉阻塞病人早期行视网膜激光光凝治疗,可促进视力时恢复和视网膜下出血吸收及黄斑水肿的消退,预防新生血管和玻璃体出血的发生。     

Experimental retinal branch vein occlusion

Experimental retinal branch vein occlusion was produced in monkeys (macaca irus) by dye laser photocoagulation (yellow wavelength 577nm The 920 ARGON/DYE Laser System, Coherent Radiation). The Clinical process was observed based on ophthalmoscopic and fluorescein angiographic alterations which occur during the natural history of experimental branch vein occlusion. Immediately after occlusion, venous dilatation, retinal edema and punctate hemorrhage, were recognized by ophthalmoscopy, and leakage of dye from postcapillary venules, followed later by additional leakage from large veins were observed frequently by fluorescein angiography. Circulatory disturbances remained over 3-4 days, and the retinal branch vein occlusion were persisted. Ten days later, a non-perfusion area was observed by fluorescein angiography. More than 1 year later, these nonperfusion area remained.     

Experimental retinal branch vein occlusion

Experimental retinal branch vein occlusion in monkeys (macaca irus) were produced by yellow wavelength (577nm) dye laser photocoagulation. The clinical sequence was observed in terms of the structural and ultrastructural findings occurring during the natural history of experimental branch vein occlusion, particularly in the early stage. Immediately after the occlusion, venous dilatation and retinal edema and hemorrhage appeared. Extravascular leakage of dye in fluorescein angiography and hemorrhage appeared from small venules at an early stage. Leakage from the larger vessels was observed later. Opening of the intercellular junctional complexes, which signifies breakdown of the blood-retinal barrier was detected by electron microscopy. Subsequently degenerative or necrotic changes in endothelial cells appeared with the formation of intravascular thrombi and extravascular leakage of blood components appeared from these vessels.     

Thrombus and branch retinal vein occlusion

Branch retinal vein occlusion (BRVO) is often associated with arteriosclerosis. Typically the occlusion occurs at an arteriovenous crossing. We report a case of a previously healthy patient who developed a BRVO. Funduscopy and fluorescein angiography suggested an intravascular thrombus as the cause of the occlusion. The investigations performed were positive for systemic hypertension and hyperlipidaemia. After 2 months, fundus examination revealed disappearance of the intravascular thrombus, resolution of the macular edema and improvement of the — visual acuity. Certain physiological characteristics of the retinal circulation associated with hyperlipidaemia and systemic hypertension appear to favour thrombus formation.