多波长氪激光治疗视网膜大动脉瘤的疗效观察

视网膜大动脉瘤是指视网膜中央动脉主干或其分支局限性扩张。本病好发于颞侧视网膜动脉的第 3分支以前 ,瘤壁因渗漏、破裂而出现的视网膜水肿、渗出、出血 ,极易波及黄斑中心凹 ,严重影响视力[1 ] 。由于其发病机制尚不清楚 ,临床上缺乏有效的药物治疗方法。我院 1997年 1月～ 2 0 0 0年 11月采用氪离子激光光凝治疗视网膜大动脉瘤 8例 8只眼 ,疗效显著 ,现报告如下。1　对象和方法从 1997年 1月至 2 0 0 0年 11月间在我科确诊为视网膜大动脉瘤患者中选取病变波及黄斑的 8例 8只眼 ,采用氪离子激光光凝并进行随访。诊断主要依据荧光素眼底血…     

康柏西普联合多波长激光光凝治疗视网膜大动脉瘤

目的:观察玻璃体内注射康柏西普联合多波长激光光凝治疗视网膜大动脉瘤的临床效果。方法:前瞻性临床随机对照研究。将郑州大学第一附属医院2016年1月至2019年12月视网膜大动脉瘤32例(32眼)纳入本研究。患者随机分为两组,A组行康柏西普玻璃体内注射联合多波长激光光凝治疗,B组行单纯多波长激光光凝治疗。随访6个月,观察两...     

多波长氪离子激光治疗糖尿病视网膜病变

目的观察多波长氪离子激光对糖尿病视网膜病变的疗效。方法用多波长氪离子激光对35例糖尿病视网膜病变患者55只眼,根据病变性质、部位和屈光间质情况选择不同波长激光进行视网膜光凝,术前行视力、裂隙灯、 检眼镜、眼压、眼B型超声、视野、视觉诱发电位和荧光素眼底血管造影检查,术后随访1年 。结果20只眼视力提高,占36.4%,视力无变化34只眼,占61.8%,视力下降1只眼,占1.8%,其间未见严重并发症。结论多波长氪离子激光,可依实际需要组合使用不同波长治疗糖尿病视网膜病变,使部分患者视力提高。远期效果有待进一步观察。(中华眼底病杂志,2001,17:178-180)     

多波长氪离子激光治疗糖尿病视网膜病变

目的 观察多波长氪离子激光治疗糖尿病视网膜病变的疗效。方法 采用多波长氪离子激光对70例115眼Ⅲ～Ⅳ期糖尿病视网膜病变的患者，根据病变的性质、部位和屈光间质情况选择不同波长激光进行全视网膜光凝，术前进行视力、裂隙灯、眼底和眼底荧光血管造影检查，术后随访10～40个月，平均18个月。结果 显效58眼，占50．5％，47眼(41％)疗效尚可，无效10眼，占8．7％。其间未见严重并发症。结论多波长氪离子激光治疗糖尿病视网膜病变具有的优越性，可根据病变情况选择不同的波长进行光凝治疗，对提高或保存患者的有用视力疗效肯定。     

多波长氪激光治疗糖尿病视网膜病变

我科对218例糖尿病视网膜病变（diabetic retinopathy,DR）患者行多波长氪激光光凝治疗,现报告如下。     

视网膜大动脉瘤

报告视网膜大动脉瘤一例，患者为69岁女性，有高血压。可见瘤体与脉搏一致的搏动，瘤体急性失代偿出血，并在出血后萎缩。 （中华眼底病杂志，1993，9：98-99）     

氪多波长激光治疗和预防视网膜脱离临床分析

目的 分析氪多波长激光治疗和预防视网膜脱离的效果。方法 用氪多波长激光治疗和预防视网膜脱离患者188例（193眼）。结果 视网膜周边干性裂孔和视网膜周边变性单纯用氪多波长激光治疗15眼，成功100％；局限性孔源性视网膜浅脱离10眼，先使用脱水剂、卧床休息、单眼加压包扎等措施，而后行激光治疗，成功率80％，2眼因玻璃体有牵引结合局部垫压术后成功；巩膜外扣带术后激光封孔141眼，成功率96．5％。5眼因玻璃体有牵引行玻璃体手术后眼内激光封闭裂孔成功；复杂性视网膜脱离经玻璃体切割手术，术中及术后激光封闭裂孔27眼，成功100％。结论 氪多波长激光治疗和预防视网膜脱离成功率高，创伤小，对于周边视网膜干性裂孔和变性激光治疗可以预防视网膜脱离的发生。激光可根据病情在术中术后选择，作为常规视网膜脱离手术和玻璃体手术的补充治疗。     

多波长氪激光治疗视网膜分支静脉阻塞的疗效分析

目的:通过分析142例多波长激光治疗视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)的效果,讨论多波长激光在治疗BRVO中的重要意义。方法:通过对142例142眼BRVO患者应用美国科医人公司生产的多波长氪激光仪进行光凝治疗,在3mo后进行视力、眼压、裂隙灯、眼底镜及FFA检查,总结分析视力变化、视网膜出血吸收情况、黄斑水肿吸收情况。结果:经激光光凝治疗后3mo,出血吸收原面积的1/2以上者51眼(35.9%),吸收1/2～3/4者62眼(43.7%),吸收3/4至完全吸收者29眼(20.4%),同时,黄斑水肿完全吸收33眼(23.2%),黄斑水肿明显吸收96眼(67.6%),黄斑水肿轻度吸收或无变化13眼(9.2%)。治疗3mo后复查FFA,发现新生血管完全消退占有新生血管患者的71.2%,部分消退者占28.6%,无变化或加重仅占0.2%。结论:不失时机的应用多波长氪激光光凝治疗BRVO能明显提高视力,促进视网膜出血和黄斑水肿的吸收,同时可预防严重并发症的产生。     

多波长氪离子激光治疗糖尿病视网膜病变的疗效观察

目的观察多波长氪离子激光治疗糖尿病视网膜病变的疗效。方法采用多波长氪离子激光对100例（185只眼）Ⅲ～Ⅳ期糖尿病视网膜病变患者,根据病变的性质、部位和屈光间质情况选择不同波长激光进行不同方法视网膜光凝,术前进行视力、裂隙灯、眼底和眼底荧光血管造影检查,术后随访12～36个月,平均22个月。结果显效98只眼,占52．97％,有效74只眼,占（40％）,无效13只眼,占7．03％,随访其间未见严重并发症发生。结论多波长氪离子激光治疗糖尿病视网膜病变具有优越性,可根据病变不同情况选择不同的波长进行治疗,能提高或保存患者的视力。     

多波长氪离子激光治疗糖尿病视网膜病变疗效观察

目的观察多波长氪离子激光对116例(182眼)糖尿病视网膜病变(DR)的疗效。方法根据患者病变性质、部位、分期和屈光间质情况分组,选择不同波长激光进行不同方法视网膜光凝。局部光凝组124眼,全视网膜光凝组58眼,术前均行视力、检眼镜、裂隙灯显微镜加三面镜和荧光素眼底血管造影检查,术后随访1～1.5年。结果局部光凝组病变较轻40眼,病变较重84眼,治疗1次后随访显示二者疗效有显著性差异(P<0.05)。全视网膜光凝组,其中增生前期DR26眼,光凝后有效22眼(85%)、无效4眼(15%)。增生期DR32眼,光凝后有效20眼(63%)、无效12眼(37%)。结论多波长氪离子激光是治疗DR的有效方法,依据病变情况使用不同波长扩大了治疗DR的适应证。早期进行局部光凝治疗DR可减少治疗次数和并发症。     

视网膜大动脉瘤的临床特点及多波长氪离子激光治疗观察

目的 观察视网膜大动脉瘤(RAM)的临床特点及激光治疗效果。方法 回顾分析2015年1月~2018年12月在我院激光治疗的23例(23眼)RAM患者的临床资料。分析眼底彩照、荧光血管造影及激光治疗效果。结果 23例患者年龄33~86岁,平均(63.39±13.22)岁,<50岁4例(17.39%),>50岁19例(82.61%)。合并高血压病的患者16例(69.57%)。男性∶女性为8∶15。均为单眼发病。22例颞侧发病,其中15例为颞上方,7例为颞下方;1例鼻上方发病。22例为单发,1例为2个瘤体。视力:指数~0.6。对所有患者进行多波长氪离子激光治疗后3~6个月随访视力、眼底彩照,并复查荧光眼底血管造影,发现所有患者动脉瘤体均完全或部分萎缩、闭塞,渗出、出血逐渐吸收,视力提高18例、不变5例,无视力下降者,未出现瘤体破裂等并发症。激光治疗前后最佳矫正视力(BCVA)(LogMAR视力)分别为0.54±0.11、0.39±0.08,治疗后较治疗前有明显提高,差异有统计学意义(P<0.05)。结论 RAM好发于老年女性,绝大多数单眼发病,多数为单发病灶,临床特点明确,荧光血管造影可明确诊断并进行随访。多波长氪离子激光治疗RAM安全有效。     

Familial retinal arterial macroaneurysms

PURPOSE: To describe the salient clinical features and course of a new entity. METHOD: Retrospective study of the clinical examinations, photographic and angiographic documentation, and clinical course of seven children from three unrelated Saudi families with multiple retinal arterial macroaneurysms. RESULTS: There were four females and three males: one set of two sisters (patients 1 and 2), a brother and a sister (patients 3 and 4), and a sister and two brothers (patients 5, 6 and 7). The age at first symptoms ranged from 3 months to 19 years. The first four cases were labeled for many years as "atypical bilateral Coats." Each patient demonstrated the presence of beading and macroaneurysms along the major retinal arterial trunks bilaterally. In five patients, recurrent bleeding and leakage from these macroaneurysms occurred, resulting in visual loss. The blood was mainly located under the internal limiting membrane. It reabsorbed spontaneously in all patients, with improved visual acuity. In three patients, argon laser photocoagulation of leaking macroaneurysms was followed by clinical improvement. Follow-up ranged from 18 months to 17 years (average = 7.8 years). CONCLUSION: The authors report, to the best of their knowledge, a new condition that they propose to call "familial retinal arterial macroaneurysms."     

Ranibizumab for retinal arterial macroaneurysms

Graefe's Archive for Clinical and Experimental Ophthalmology -     

Morphometrical analysis of retinal arterial macroaneurysms

Twenty-one macroaneurysms and related vessels of 19 patients were evaluated morphometrically. Macroaneurysms were classified into two groups as hemorrhagic and exudative in terms of their major clinical sign. Average diameters of the macroaneurysms were arranged in a Gaussian distribution curve (mean and standard deviation: 281.60 ± 57.28 micrometers). Regarding the distribution curve based on this data macroaneurysm can be defined as being greater than 109.76 micrometers. Macroaneurysms were most frequent on the superotemporal vessels (52.38%), followed by the inferotemporal (38.10%), inferonasal (4.76%) and superonasal vessels. Average diameter (r=+0.68, p=0.0006) and area (r=+0.71, p=0.0003) of the macroaneurysms were significantly correlated to the diameter of the relevant arterial segments. The distribution of the macroaneurysms in respect to arterial bifurcation (X ²=18.762, p=0.0003) and arteriovenous crossings (X ²=8.286, p=0.0405) were nonrandom with macroaneurysms clustering near this points. Hemorrhagic macroaneurysms were significantly closer to the optic disc (p<0.01) and were located on relatively larger arterioles (p<0.01). They were also more circular (p<0.01) in shape and greater in area (p<0.01) and diameter (p<0.01) than the exudative ones. These findings suggest that the location of the macroaneurysm is closely related to its clinical appearance.     

Vascular networks in retinal arterial macroaneurysms

Retinal arterial macroaneurysms (MA) are a rare pathology, often associated with old age, arterial hypertension, artherosclerosis, and retinal vein occlusions. Here, we present two unusual cases of MA in patients with arterial hypertension, that displayed small vascular networks at the site of the MA on angiography. Resulting exudative changes and the networks themselves regressed after laser treatment, and visual acuity improved. Those vascular networks might represent collateral vessels forming as a rare sequel after spontaneous occlusion of the MA. None of the authors has a proprietary interest in the presented cases.     

视网膜大动脉瘤临床观察

目的 总结视网膜大动脉瘤(retinal arterial macroaneurysms)的临床特点以提高其首诊诊断准确性。方法 对13例(13只眼)首诊诊断为其他眼底病的视网膜大动脉瘤患者行全身系统及眼科常规检查,重点是眼底荧光血管造影检查(眼底彩色照相 FFA,fundus fluorescein angiography)。部分行OCT(optical coherence tomography)检查。结果 13例患者均为单眼;12例患者为单个大动脉瘤,1例患者有2个大动脉瘤;瘤体均位于颞侧,颞上支6只眼,颞下支8只眼(有1例患者的大动脉瘤1个位于颞上支,另1个位于颞下支);动脉瘤位于第1级分支1只眼,第2级分支9只眼,第3级分支3只眼。13例患者中有高血压病病史者11例,有糖尿病病史者2例;眼底可见动脉硬化10例,伴视网膜动脉血管先天异常2例。6例行OCT检查,发现黄斑视网膜神经上皮层水肿(包括囊样水肿)6只眼,黄斑区视网膜神经上皮层脱离2只眼,黄斑区视网膜前膜形成2只眼。结论 眼底血管造影及眼底彩照有助于视网膜大动脉瘤的早期正确诊断,OCT有助于发现轻微的黄斑形态改变。     

视网膜大动脉瘤临床分析

目的观察视网膜大动脉瘤的临床特征和荧光素眼底血管造影及吲哚菁绿血管造影（FFA、ICGA）及相干光断层扫描（OCT）的图像特征,提高其诊断准确性。方法对14例诊断为视网膜大动脉瘤患者的临床资料和FFA、ICGA及OCT等检查结果进行回顾性分析。结果14例患者中男性5例,女性9例。年龄57～82岁,平均71岁。多数患者伴有高血压、糖尿病等病史。均为单眼发病,单个大动脉瘤瘤体均位于视网膜颞侧动脉分支,其中颞上支动脉10例,颞下支动脉4例;动脉瘤都位于2—3级分支内。瘤体呈灰黄色或红色,周围有不同程度的视网膜出血和环形或弧形渗出。FFA和ICGA检查显示动脉瘤呈圆点状强荧光,晚期有不同程度的荧光渗漏和瘤体壁染,出血呈遮蔽荧光。OCT图像显示视网膜出血使视网膜隆起,视网膜内呈现高反射,出血为暗区,遮挡下方组织反射,水肿呈低反射;可伴有视网膜神经上皮的出血性和（或）浆液性脱离,呈现低反射。结论FFA和ICGA检查有助于视网膜大动脉瘤的早期正确诊断;应掌握视网膜大动脉瘤的临床特征和FFA、ICGA及OCT的图像特征,注意与渗出型年龄相关性黄斑变性（AMD）、成人型Coats病等眼病相鉴别。     

Argon laser treatment of retinal macroaneurysms

The necessity of treatment of retinal macroaneurysms is still a subject of discussion since some macroaneurysms may heal without any treatment with good recovery of vision while others are the cause of lasting visual impairment. So far only a few reports have been published concerning the results of treatment. In this article we present six patients with a diminished visual acuity in one eye caused by a retinal macroaneurysm. The results of laser-coagulation in five of these are demonstrated. One patient showed spontaneous disappearance of a macroaneurysm. Some aspects of the method of photocoagulation are discussed briefly.     

Multiple retinal arterial macroaneurysms associated with submacular hemorrhage

Purpose. To present the unusual case of multiple retinal arterial macroaneurysms (RAMs) associated with an extensive submacular hemorrhage. Methods. A 64-year-old hypertensive woman is presented including the clinical findings, fluorescein angiography, and optical coherence tomography. Results. The patient presented with 20/200 vision due to a dense submacular hemorrhage in the right eye. Fluorescein angiography revealed 4 hyperfluorescent lesions along the inferotemporal arteriole corresponding to RAMs. Optical coherence tomography confirmed RAM rupture with no choroidal abnormality. The patient refused surgical intervention. At 3-month follow-up, vision had improved to 20/70 with partial resolution of the hemorrhage. However, vitreoretinal traction with neurosensory retinal detachment involving the macula had developed. Conclusions. Acquired RAMs are typically found as unilateral solitary lesions in older hypertensive women. The presence of 4 RAMs along the same arteriole has not been reported previously. Hypertensive patients should be examined regularly in order to detect potential RAMs early enough to permit treatment and prevent vision loss.