眼压和轴长在视网膜中央静脉阻塞中的意义

目的　探讨眼压和轴长在视网膜中央静脉阻塞中的意义。方法　应用TX- 10眼压计对4 6例(46只眼) CRVO患者的眼压进行测量。并使用A型超声仪对其中16例CRVO眼轴进行测量,对照组与病例组年龄和性别相配,例数相等。结果　36例CRVO阻塞眼眼压较对侧眼有不同程度降低。CRVO阻塞眼眼压显著低于对侧眼及正常对照眼(P <0 .0 1)。CRVO阻塞眼轴长显著短于对侧眼及正常对照眼(P <0 .0 1)。结论　CRVO可引起眼压降低,短眼轴是CRVO的危险因素。     

放射状视神经切开术治疗视网膜中央静脉阻塞的效果观察

目的观察放射状视神经切开术(RON)治疗视网膜中央静脉阻塞(CRVO))的效果。方法CRVO患者7例(7眼),均进行眼科常规检查、眼底荧光血管造影(FFA)和光学相干断层扫描(OCT)检查后确诊。行标准三通道闭合式玻璃体切除手术后,使用改良的MVR刀在视盘鼻侧缘做放射状视神经切开术。结果术中和术后无严重并发症。6例术后视网膜出血、静脉迂曲扩张和黄斑水肿等视网膜淤滞状态逐渐消退,视力均有不同程度的提高。1例年轻患者术后发生玻璃体积血。结论RON手术可以改善CRVO的视网膜淤滞状态和提高视力,但需要进一步观察手术的远期效果。     

Retino-choroidal ischemia in central retinal vein occlusion

A 41-year-old gentleman with insulin dependent diabetes had decreased vision in the right eye due to non-ischemic central retinal vein occlusion with macular edema. One month following intravitreal ranibizumab, he developed retino-choroidal ischemia with further loss of vision. Authors show the fluorescein angiographic transition from non-ischemic central retinal vein occlusion to retino-choroidal ischemia.     

眼压在视网膜静脉阻塞中的意义

目的:探讨眼压在视网膜静脉阻塞中的意义。方法:应用TX-F眼压计对23例23眼,视网膜静脉阻塞(retinal vein occlusion,RVO)患者的眼压进行测量。对照组与病例组年龄和性别相配,例数相等。结果:18例RVO阻塞眼眼压较对侧眼有不同程度降低。RVO阻塞眼眼压显著低于对侧眼及正常对照眼(P<0.01)。结论:RVO可引起患者眼压降低。     

Bilateral retinal venous occlusion in pigmentary glaucoma

Background The association of central retinal vein occlusion with primary open angle glaucoma is well known. This communication reports the occurrence of branch retinal vein occlusion and central retinal vein occlusion in a case of pigmentary glaucoma.Methods A 32-year-old man presented with old branch retinal vein occlusion in one eye and resolving central retinal vein occlusion in the other eye. Examination revealed bilateral Krukenbergs spindle and hyperpigmented trabecular meshwork. Intraocular pressure was 30 mmHg OU. Topical antiglaucoma medication was prescribed.Results Intraocular pressure was controlled with topical antiglaucoma medication.Conclusion The present report suggests that intraocular pressure monitoring is important in eyes even with branch retinal vein occlusion. Pigment dispersion may be the underlying cause for bilateral retinal vein occlusion, especially in young patients.     

视网膜中央静脉阻塞病因的研究进展

视网膜中央静脉阻塞（CRVO）是临床上常见的视网膜疾病,因其严重的并发症导致视力下降甚至失明,到目前为止,其病因尚未明确。近年来,随着科学技术的进步,人们对于该病基础与临床研究不断深入,有关本病的病因方面有一些新的认识和进展,本文对其病因研究进展作一简要综述。     

"二步法"激光诱导脉络膜视网膜静脉吻合术治疗兔视网膜中央静脉阻塞的视觉电生理变化

目的评价“二步法”激光诱导脉络膜视网膜静脉吻合术(laser-induced chori-oretinal venous anastomosis,LCRVA)治疗实验性视网膜中央静脉阻塞(central retinal veinocclusion,CRVO)的有效性。方法青紫蓝兔30只,8只(16眼)设为正常对照组,其余22只(44眼)采用光动力学方法建立双眼的CRVO模型。CRVO模型成功后,对双眼CRVO兔(15只),随机选1眼先后用倍频Nd:YAG激光器和Nd:YAG激光器分别在选定部位击破Bruch膜及相邻的静脉壁,以建立视网膜静脉与脉络膜血管之间的吻合通道;对侧眼作为CRVO对照眼;4只单眼CRVO兔中,2只为LCRVA治疗组,另2只为CRVO对照组。于术前1d,术后4h、1d、3d、1周、2周、3周、4周、8周、12周和16周各时间点,分别进行ERG检测。结果34眼(77.3%,15只兔双眼,4只兔单眼)一次性建立了CRVO模型。对其中的17眼行LCRVA,每眼击射2个点。经眼底荧光素血管造影检查证实,在8眼(47.0%)中的11个点(32.4%)存在功能性吻合。CRVO对照组较正常对照组在各时间点主要表现为ERG b波潜伏期延长,振幅下降。经LCRVA治疗后2~3周,b波振幅呈恢复趋势,与CRVO对照组有显著性差异(P<0.05)。OPs波振幅与ERG b波呈现相似变化。ERGa波变化不明显。结论兔CRVO眼的视网膜功能明显受损,LCRVA可一定程度减轻CRVO对视功能的损害。     

Combined central retinal vein and cilioretinal artery occlusion

We present a case of combined central retinal vein and cilioretinal artery occlusion which, due to the absence of the temporal branch retinal artery, was initially misdiagnosed as a combined central retinal vein occlusion and temporal branch retinal artery occlusion. Given that – in contrast to cases of combined central artery and central retinal vein occlusion – the prognosis for cilioretinal artery occlusion with central retinal vein occlusion is quite good, this case illustrates the importance of suspecting an unusual condition in the presence of a combined occlusion.     

眼球轴长与视网膜中央静脉阻塞关系的探讨

目的探讨眼球轴长与视网膜中央静脉阻塞(centralreinalveinocclusion,CRVO)的相关关系.方法采用A超测量30例CRVO患者及120例年龄匹配的正常人及白内障摘除患者眼球轴长.结果CRVO组患眼平均轴长(22.54±0.74)mm,对侧眼平均轴长(22.95±0.92)mm;经统计学处理,差异无显著性(t=2.94,P>0.05).对照组右眼平均轴长(23.45±0.66)mm,左眼平均轴长(23.56±0.95)mm,左右眼比较差异无显著性(t=1.96,P>0.05).CRVO组患眼与对照组轴长比较,差异有显著性(t=4.09,P<     

Cavernous sinus thrombosis elicited by a central retinal vein venous stasis retinopathy

Background Central retinal vein occlusion is a relatively common retinal disorder in the elderly, and those with cardiovascular or thrombophilic risk factors are at increased risk. Although still unsatisfying, some treatments for the acute and chronic phases have been established based on randomized studies. However, for rare conditions mimicking central retinal vein occlusion, treatment of the acute phase should be targeted at etiology. A rare condition mimicking central retinal vein occlusion in a 70-year-old man is presented and discussed.Methods A 70-year-old man was admitted to the hospital for isovolemic hemodilution related to a central retinal vein occlusion of the elderly, after a sudden decrease in visual acuity to 0.1.Results Clinical and laboratory work-up demonstrated a venous stasis retinopathy, related to an atypical cavernous sinus thrombosis of undetermined origin. The patient had experienced in the past 6 months intermittent diplopia and an irreducible conjunctival hyperemia. Hemodilution was dismissed. Soon after initiation of anticoagulation therapy, the patients clinical signs and symptoms improved. Final visual acuity was 0.8.Conclusion Venous stasis retinopathy secondary to cavernous sinus thrombosis is rare. However, careful clinical examination and extensive laboratory work-up is needed to exclude central retinal vein occlusion not associated with common vascular pathologies of the elderly.No financial interest. No grant.     

Unilateral central retinal vein occlusion as a first manifestation of diabetes mellitus in a ten-year-old girl

Central retinal vein occlusion (CRVO) is relatively rare in the pediatric age group. We present a case of CRVO as the first manifestation of diabetes mellitus in a ten-year-old girl. The associated macular edema was managed successfully with a single injection of Ranibizumab. Ophthalmologists should consider the possibility of diabetes mellitus in pediatric cases of CRVO.     

視網膜中央静脈阻塞與球后血流動力學及血液流變學相關性研究

目的探討視網膜中央静脈阻塞(CRVO)患者的視網膜中央動脈(CRA),眼動脈(OA)的血液動力學、血液流變學改變及其相互關系.方法采用美國AcusoN-128XP/10彩色多普勒成像(CDI)技術檢測23例CRCO患者和23例正常人CRA.OA血液動力學及血液流變學改變.結果 CRVO患者CRA收縮期最大血流速度(Vmax)比對側眼(P＜0.05)及對照眼(P＜0.01)下降,舒張末期最小血流速度(Vmin)比對側眼及對照組顯著性增高(P＜0.05),阻力指數(RI)比對側眼(P＜0.05)及對照組(P＜0.01)增高.低切率全血比粘度較對照組顯著性增高(P＜0.01),并與CRAO患者Vmax(r=-0.641 P＜0.01)、Vmin(r=-0.538 P＜0.01)成負相關.結論 CRVO患眼CRA的CDI參數异常,表明動脈血流速度的下降與CRVO發病相關,CRA供血减少是引起視網膜損害的主要原因之一.低切率全血比粘度增高是導致CRVO患眼CRA血流下降因素之一.     

Central retinal vein occlusion in young people

In a study performed on 20 subjects with central retinal vein occlusion (CRVO) aged 40 years or less we found the ischemic form in 20%. Disc edema was a common finding at the onset, while macular edema was less frequently seen. Systemic or ocular disorders that could be related with the development of the CRVO were often found; a patient was affected with myasthenia gravis and another with Sturge-Weber syndrome: these two diseases were not previously reported in association with CRVO. In only two of the 11 patients followed-up the visual acuity improved. The visual prognosis in CRVO of young people is often poor; the more frequent cause of the reduced visual acuity is chronic cystoid macular edema.     

Hyperhomocysteinemia and central retinal vein occlusion in Iranian population

Purpose To evaluate total plasma homocysteine level during the acute phase of central retinal vein occlusion (CRVO) in the Iranian population and determine whether hyperhomocysteinemia is also a risk factor for CRVO. Methods Fifty-four patients with recently diagnosed CRVO were studied. Their fasting total plasma homocysteine level was compared with a matched control group of 51 patients evaluated in the same clinic for a non-retinal disease diagnosis. Results The mean total plasma homocysteine level was 14.76 ± 7.67 μmol/l in cases, and 11.42 ± 3.74 μmol/l in control subjects. It showed a significant difference (P = 0.005) in mean plasma homocysteine level between cases and control group. Odds ratio of CRVO for individuals with hyperhomocysteinemia was 2.88 (95% CI = 1.08−7.71 and P = 0.03). The overall multivariable-adjusted odds of CRVO in participants with plasma homocysteine level above 15 μmol/l was 4.71 (95% CI = 1.46−15.19 and P = 0.009) Hyperhomocysteinemia was not statistically different in each age group (< 60 years: 27%, 61−70 years: 33.3%, 71−80 years: 31.6%, > 81 years: 33.3%, Chi-square test, P = 0.98). Conclusion Elevated total plasma homocysteine level is an independent risk factor for CRVO in Iranian population. In addition to an evaluation of all conventional cardiovascular risk factors, measurement of total homocysteine for evidence of hyperhomocysteinemia may be important in the initial investigation and management of patients with CRVO.     

Combined central retinal artery-central vein obstruction

The cases of 23 patients with unilateral combined central retinal artery-central retinal vein obstruction are described. Criteria for the abnormality included: a history of relatively sudden visual loss; superficial retinal whitening in the posterior pole in combination with a cherry spot; and intraretinal blood, generally associated with dilated and/or tortuous retinal veins. In five instances (22%) the obstructions developed after retrobulbar injection. Among the 21 patients with followup for at least 6 months, or until the onset of neovascularization of the iris, 17 (81%) developed rubeosis iridis.Late histopathology was obtained in two eyes. Hemorrhagic necrosis of the retina was observed in some areas of the posterior pole and attenuation of the inner retinal layers, similar to that seen with late central retinal artery obstruction, was noted elsewhere. Periphlebitis of the central retinal vein within the optic nerve was found in each case.     

Natural course of experimental retinal vein occlusion in rabbit; arterial occlusion following venous photothrombosis

BACKGROUND: Retinal vein occlusion (RVO) is the second leading cause of vascular eye disease. Currently there is no definite treatment for this condition. Animal models could be potentially helpful in developing new treatments; however, it is essential to understand the differences these models may have with human RVO. The aim of our study was to examine the course of experimentally created retinal vein occlusion (RVO) in rabbits. METHODS: Twenty-nine pigmented rabbits were included in the study. RVO was created in all using an argon green laser following intravenous injection of Rose Bengal. A laser was applied to all major veins at the optic disc margin to mimic central retinal vein occlusion. Animals were followed-up for a maximum of 2 months. RESULTS: Immediately following laser application, blood flow ceased or the flow was extremely slow in the retinal veins in all cases. At day 2 post laser, 86% showed significant retinal hemorrhages. On FA, no retinal blood flow was observed in the eye (neither arteries nor veins) in the majority of rabbits. Between weeks 1 and 3, laser sites reopened and partial or complete revascularization of both retinal arteries and veins occurred; however, the vascular pattern was abnormal. CONCLUSIONS: RVO in rabbits has a different course than in human and it can be classified into three stages. At stage 1 (the first few days after laser photothrombosis), there is a retrograde propagation of the blood clot in the retinal veins that extends to the retinal arteries and choriocapillaries. As a result, there is no retinal blood flow at this stage in most cases. At stage 2 (between weeks 1 and 3), partial or complete revascularization occurs but the vessels have an abnormal pattern. At stage 3 (after week 3) no significant change takes place.     

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)     

Ophthalmodynamometry and corticosteroids in central retinal vein occlusion

Purpose : This is the first report of the monitoring of the clinical progress of a central retinal vein occlusion by measuring the retinal venous collapse pressure using ophthalmodynamometry.
Method : A 38-year-old woman with a non-ischaemic central retinal vein occlusion received systemic prednisone. The dose of prednisone was increased and decreased both abruptly and gradually. The response was monitored by weekly measurements of visual acuity, retinal appearance and retinal venous collapse pressure. The retinal appearance was assessed by comparison of repeated stereo colour photographs and fluorescein angiographs. Retinal venous collapse pressure was estimated by taking the mean of four or more ophthalmodynamometric measurements.
Results : An inverse relationship between the ophthalmodynamometric retinal venous collapse pressure and systemic prednisone dosage was observed. The visual acuity and retinal appearance remained unchanged throughout the follow-up.
Conclusions : Ophthalmodynamometry in this case was a useful method of quantitatively monitoring the response of central retinal vein occlusion to systemic prednisone. The response would not have been detected if only visual acuity and retinal appearance were used to monitor the progress.     

缺血型视网膜中央静脉阻塞全视网膜光凝的疗效观察

目的探讨全视网膜光凝治疗缺血型视网膜中央静脉阻塞的临床效果。方法回顾性分析2003年1月至2005年4月我院收治的缺血型视网膜中央静脉阻塞共68例68眼,其中行532 nm激光全视网膜光凝治疗40眼(激光组),28眼末行532 nm激光全视网膜光凝(对照组),观察对比两组初、末诊视力,新生血管及新生血管性青光眼等并发症情况。随访时间均在8个月以上,平均随访11±2.3个月。结果两组末次随访视力、虹膜新生血管及新生血管性青光眼等并发症发生率有所不同,但比较差异无统计学意义(P>0.05)。结论缺血性CRVO严重损害患者视力,需要积极治疗,全视网膜光凝对于对于预防虹膜新生血管及新生血管性青光眼的疗效不确切。     

Treatment of central retinal vein occlusion by radial optic neurotomy in 107 cases

Background To evaluate the potential role of radial optic neurotomy (RON), a new surgical technique has been recently proposed for treating central retinal vein occlusion (CRVO). It is hypothesized that CRVO constitutes a neurovascular compartment syndrome at the site of the lamina cribrosa, which can be alleviated by performing a radial incision at the nasal part of the optic nerve head, relaxing the cribriform plate and the adjacent sclera. Methods One hundred and seven patients were treated with RON for CRVO at five collaborating ophthalmologic centers. All patients were evaluated by a standardized protocol. For analysis of the angiographic and fundus findings, reference images were used. Intraoperative and postoperative complications were reviewed. Results On 55 right and 52 left eyes of 107 patients (55.6% male, 44.4% female) with a median age of 68 years (range 21–91 years), RON was performed. The median follow-up time was 6 months (range 1–24 months). The median preoperative visual acuity (VA) was 0.05 (logMAR 1.3), increasing to a median postoperative VA of 0.08 (logMAR 1.1). Patients with an interval of more than 90 days between RON and onset of CRVO showed no significant change in VA at the 6-month follow-up. Severe peripapillary swelling of the optic nerve head prior to RON resulted in an average increase of 4.2 lines in VA at the 6-month follow-up. Angiographic findings of shunt vessels were seen in 18/30 cases after 12 months and were accompanied by an average improvement of VA of six lines. Visual field tests showed various defects in 86.8% of all cases. In one patient an iatrogenic injury of the central retinal artery occurred (0.9%). Conclusion Despite the potential risk of visual field defects, RON seems to be a quite safe procedure. The majority of patients showed rapid normalization of the morphologic fundus findings, with an improvement in VA uncommon for the natural history of CRVO. No significant change in VA was seen in patients with an interval of more than 90 days between the onset of CRVO and RON. A prospective study is warranted for further investigation. The authors have no proprietary interest, are not sponsored by any organisation, and received no grant in connection with the study herein.