视网膜静脉阻塞分型与视网膜循环时间关系相关分析

目的 探讨视网膜静脉阻塞(RVO)分型与视网膜循环时间(RCT)的关系.方法 对48例(48眼)有视网膜静脉阻塞的患者,按眼底荧光血管造影(FFA)确定的RCT进行分型.将>5 s的定为缺血型(HR)24例,其中视网膜中央静脉阻塞(CRVO)12例和分支静脉阻塞(BRVO)12例,≤5 s的定为非缺血型(VSR)24例,其中(CRVO)14例和(BRVO)10例.结果 CRVO和BRVO中HR的RCT均有明显延长(P<0.01).结论 以RCT进行RVO的分型方法,简单明确.对RVO的早期治疗和判断预后具有重要的临床价值.     

视网膜静脉阻塞危险因素的条件Logistic回归分析

目的:探讨视网膜静脉阻塞(RVO)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:采用病例对照研究。患者组为86例病程在3个月内、经荧光素眼底血管造影确诊、未进行过药物治疗的RVO患者。对照组为86例健康查体者,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。患者组又按阻塞类型分为中央静脉阻塞(CRVO)和分支静脉阻塞(BRVO)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、高脂血症和糖尿病的发生率明显高于对照组(P=0.005,P<0.001,P=0.014),与RVO发病呈正相关,而心、脑血管疾病,开角型青光眼的发生率以及吸烟和饮酒生活习性上差异无统计学意义(P>0.05)。BRVO组中,患高血压、高脂血症和糖尿病的比例明显高于对照组(P=0.024,P< 0.001和P=0.022),CRVO组只有患高血压和高脂血症的比例高于对照组(P=0.029和P=0.028)。结论:高血压和高脂血症为RVO 发病的独立危险因素。此外,糖尿病与BRVO的发病也相关。及时诊断和治疗全身性疾患对于RVO的防治具有重要指导...     

视网膜分支静脉阻塞患者同型半胱氨酸和高敏C反应蛋白水平分析

目的探讨视网膜分支静脉阻塞(branch retinal vein occlusion, BRVO)患者血清同型半胱氨酸(homocysteine, Hcy)和血浆高敏C反应蛋白(high-sensitivity C-reactive protein, hs-CRP)水平及临床意义。方法 BRVO患者124例为观察组,体检健康者124例为对照组。采用散射免疫比浊法检测2组血浆hs-CRP水平,采用速率法检测血清Hcy水平,比较2组高同型半胱氨酸血症和hs-CRP升高发生率,观察合并高血压、高胆固醇血症的BRVO患者血浆hs-CRP和血清Hcy水平变化情况。结果观察组血浆hs-CRP[(3.48±1.54)mg/L]、血清Hcy水平[(32.60±16.94)μmol/L]高于对照组[(0.83±0.40)mg/L、(10.18±1.31)μmol/L](P0.05),高血压(33.06%)、高胆固醇血症(35.48%)、高同型半胱氨酸血症(78.23%)和hs-CRP升高(60.48%)发生率高于对照组(17.74%、16.94%、30.65%、20.97%)(P0.05);观察组合并高血压患者血清Hcy水平[(37.22±21.78)μmol/L]高于未合并高血压患者[(21.73±17.90)μmol/L](P0.05),血浆hs-CRP水平[(3.72±1.92)mg/L]与未合并高血压患者[(3.26±1.69)mg/L]比较差异无统计学意义(P0.05),合并高胆固醇血症患者血浆hs-CRP、血清Hcy水平与未合并高胆固醇血症者比较差异均无统计学意义(P0.05)。结论血浆hs-CRP和血清Hcy升高可能与BRVO发生有关,尤其对合并高血压的患者,尽早筛查有助于预防BRVO的发生和及时干预。     

532 nm激光治疗视网膜静脉阻塞患者的临床疗效

目的探讨532nm激光治疗视网膜静脉阻塞(RVO)的临床疗效。方法选取2015年2月至2017年2月该院治疗的78例RVO患者78眼,其中视网膜中央静脉阻塞(CRVO)36眼,视网膜分支静脉阻塞(BRVO)42眼,采用532nm激光治疗并观察患者的治疗效果。结果 78眼经治疗后,总有效率为88.46%,其中CRVO和BRVO治疗总有效率分别为83.33%和92.86%,比较差异无统计学意义(P0.05);患者治疗后视力较治疗前明显提高,差异有统计学意义(P0.05);患者治疗后视网膜循环时间较治疗前明显降低,差异有统计学意义(P0.05);患者治疗前后血浆黏度、纤维蛋白原、红细胞沉降率及红细胞聚集指数比较差异无统计学意义(P0.05);治疗期间均无并发症发生。结论 532nm激光治疗RVO有较好的疗效,有助于患者视力恢复,减少新生血管形成,值得临床推广使用。     

视网膜动脉和／或视网膜静脉阻塞与眼动脉内局部纤溶治疗

视网膜中央动脉阻塞(central etinal axtery occlusion,CRAO)引起视网膜急性缺血,视力严重下降,是导致盲目的急症之一。视网膜中央静脉阻塞(central　retinal vein occlu-sion,CRVO)引起视网膜毛细血管无灌注,是引起视力丧失最常见的原因。病理学已证实在CVRO早期中央静脉内存在血栓,所有CRAO病人都可能有眼动脉原发性或继发性血小板栓子,近年经眼动脉内局部纤溶(Local intra-arterialfibrinolysis,LIF)被证明是一项治疗CRAO/CRVO有前途的介入疗法。     

糖尿病合并视网膜静脉阻塞85例分析

对我院糖尿病合并视网膜静脉阻塞（retinal vein occlusion，RVO）85例分析如下。 1 临床资料 1．1 一般资料 患者85例（92眼），男33例，女52例，年龄35～72（平均62岁）。     

和血明目片治疗视网膜静脉阻塞疗效观察

目的:观察和血明目片治疗视网膜静脉阻塞(retinal vein occlusion,RVO)的治疗效果。方法:48例(48只眼)视网膜静脉阻塞患者,随机分为2组,其中治疗组24例(24只眼),给予和血明目片治疗;对照组24例(24只眼),给予尿激酶治疗。2组均以15d为1个疗程,连续服用45d。观察患者用药后视力恢复、视网膜荧光血管造影和自觉症状的改善情况。结果:治疗组治愈率为66.7%。对照组为37.5%。差异具有统计学意义(P0.05)。结论:和血明目片可有效缓解视网膜静脉阻塞的症状,能促进视网膜出血、水肿及渗出的吸收,改善视网膜微循环,提高患者的视力。     

视网膜中央静脉阻塞的治疗现状

视网膜中央静脉阻塞（central retinal vein occlusion,CRVO）是常见的高致盲率视网膜血管病之一,仅次于糖尿病视网膜病变,常因黄斑囊样水肿和新生血管生成等并发症而使视力下降,严重影响患者的生活质量.现有的CRVO治疗方法,包括药物治疗、激光治疗和手术治疗虽有一定的临床效果,但均存在不同程度的争议.笔者就目前CRVO的各种治疗方法及疗效作一简要综述.     

血脂水平与视网膜静脉阻塞关系的临床观察

目的研究视网膜静脉阻塞（RV0）患者血脂水平的变化,以探讨血脂升高是否是RV0的独立危险因素,为治疗和预防该病提供客观依据。方法采用病例对照研究,收集40例确诊为RVO且未接受过药物治疗的患者作为病例组（其中视网膜中央静脉阻塞（CRVO）患者28人,视网膜分支静脉阻塞（BRV0）患者12人）,同期健康体检且既往无眼底血管性疾病病史者40例作为对照组,两组年龄、性别无统计学差异。检测血浆总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）含量后作统计学比较。结果RV0病例组的血浆TC,TG和LDL-C水平较对照组显著升高（5．61±1．02,2．09±0．91,3．28±0．51mmol／Lvs4．26±0．91,1．26±0．9,2．68±0．48mmol／L,t=2．432,2．126,3．27,P均〈O．05）,而HDL-C水平则显著低于对照组（1．08±0．46mmol／LVS1．76±0．62mmol／L,t=-2．33,P〈O．05）i病例组中CRV0及BRV0患者的血脂四项指标比较差异无统计学意义（P均〉0．05）。结论高脂血症为RVO的独立危险因素,降血脂药物应在治疗中被考虑使用。     

116例视网膜静脉阻塞患者临床和荧光素眼底血管造影的观察和分析

目的 :分析视网膜静脉阻塞 (retinalveinocclusion ,RVO)病例的有关资料 ,以提高对该病的检查和诊断水平。方法 :对经荧光素眼底血管造影 (fundusfluoresceinangiography ,FFA)确诊的 116例患者的 12 4只眼的临床和FFA资料进行分析。结果 :CR VO(centralretinalveinocclusion)者 2 7只眼 ;半侧RVO有 8只眼。BRVO(branchretinalveinocclusion) 89只眼 ,共有 93支血管受累 ,其中颞上支占 6 4 % ,为最易受累之血管分支 ;多支血管受累的患者占单纯BRVO的 13.4 1%。另外 ,双眼RVO共 8例 ,占患者总数的 7%。有 5 6只眼存在视网膜毛细血管无灌注区 ,占总眼数的 4 5 .16 % ;有新生血管形成 18只眼 ,占总眼数的 14 .5 2 %。CRVO患者的平均年龄为 6 1.0 8岁 ,BRVO患者的平均年龄为 6 7.0 6岁 ,两者有显著差异 (t=2 .4 5 ,P <0 .0 5 )。结论 :RVO的类型和年龄有一定关系 ;诊断时要考虑双眼RVO及多支BRVO的可能性 ;联合包括直接检眼镜、前置镜和FFA等检查方法能帮助RVO的诊断和指导治疗     

Retinal vein thrombosis: pathogenesis and management

Summary. Retinal vein occlusion (RVO) is the most common retinal vascular disease after diabetic retinopathy. Owing to its multifactorial nature, however, management of this condition remains a challenge. Of the two main types of RVO, branch retinal vein occlusion (BRVO) is more prevalent than central retinal vein occlusion (CRVO). Most patients develop the disease at an elderly age, and more than half of them have associated systemic disorders (e.g. hypertension, hyperlipidemia and/or diabetes mellitus). There is no evidence to suggest routine testing for heritable thrombophilias in patients with RVO. The main cause of the visual impairment is macular edema, while neovascularization of the retina and optic disc are the most serious complications leading to vitreous hemorrhage, retinal detachment and neovascular glaucoma. Macular grid laser photocoagulation is an effective treatment for macular edema in patients with BRVO and a visual acuity of 20/40 or less. Other treatment options for reducing the edema are intravitreal steroids, anti‐VEGF drugs and vitrectomy. The recently introduced intravitreal application of steroids and anti‐VEGF drugs may prove to be a better approach for improving visual acuity. Finally, scatter panretinal laserphotocoagulation can effectively treat neovascularization and its secondary complications.     

氩激光治疗视网膜静脉阻塞

目的 :分析氩激光治疗视网膜静脉阻塞的疗效。方法 :用氩绿激光治疗视网膜静脉阻塞 4 6例 (46眼 ) ,其中中央静脉阻塞 (centralretinalveinocclusion ,CRVO) 15例 (15眼 ) ,分支静脉阻塞 (branchretinalveinocclusion ,BRVO)和半侧静脉阻塞 31例(31眼 )。治疗前后行眼底荧光血管造影。CRVO组 13眼行全视网膜光凝 ;2眼行黄斑格栅光凝。BRVO组 31眼均行象限播散光凝。结果 :CRVO组治疗后视力提高 8眼 (5 3.3% ) ,不变 4眼 (2 6 .7% ) ,下降 3眼 (2 0 % ) ,提高与不变和下降相比 ,无显著差异 (P >0 .0 5 ) ;BRVO组视力提高 2 3眼 (74 .2 % ) ,不变 4眼 (12 .9% ) ,下降 4眼 (12 .9% ) ,提高与不变和下降相比 ,有极显著差异 (P <0 .0 1)。两组相比 ,在视力提高方面无显著差异 (P >0 .0 5 )。治疗后视网膜毛细血管无灌注区均消失 ,视网膜、视乳头新生血管消退 ,视网膜出血和渗出吸收或基本吸收。结论 :激光治疗能减少视网膜静脉阻塞引起的眼内新生血管 ,以及新生血管性青光眼和玻璃体出血的发生 ,并能使黄斑水肿消退 ,从而不同程度地改善视功能。     

视网膜静脉阻塞与颈动脉病变的相关性研究

目的探讨视网膜静脉阻塞(RVO)与颈动脉病变的相关性。方法选取于山西医科大学第一医院眼科2011年1月至2013年12月诊断为RVO的患者51例(51眼)进行颈动脉多普勒超声检查,包括检测颈动脉内膜中层厚度(IMT)、斑块数量和形态、颈动脉狭窄程度以及血流动力学参数,对照组30例(30眼)。患者年龄范围为41⁸5岁(平均62.25岁)。结果经荧光素眼底血管造影确诊的51例RVO患者中,35例(68.63%,35眼)检测出颈动脉病变。其中,30例(30眼)视网膜中央静脉阻塞(CRVO)患者检出21例(70%,21眼),21例(21眼)视网膜分支静脉阻塞(BRVO)患者检出15例(71.43%,15眼)。患眼IMT增加,颈内动脉收缩期峰值血流速度(PSV)及舒张末期血流速度(EDV)降低,阻力指数(RI)值增高(P<0.05),患眼同侧及对侧颈动脉各测量值比较无统计学差异(P>0.05)。RVO组与对照组比较,颈动脉病变、高血压病、糖尿病、高脂血症均有统计学差异(P<0.05);性别、年龄、冠心病、脑卒中及是否吸烟均无统计学差异(P>0.05)。结论 RVO的发生与颈动脉病变有关,颈动脉多普勒超声检查可以客观反映视网膜血流供应状况,可作为评估RVO病情、疗效观察及预后的有效依据,对预防心脑血管意外发生有一定临床意义。     

视网膜分支静脉阻塞患者的脉络膜厚度及血流密度分析

目的分析视网膜分支静脉阻塞(BRVO)患者的脉络膜厚度及血流密度。方法选取2019年1月至2019年9月于重庆市中医院眼科门诊确诊为非缺血型BRVO的20例患者作为研究对象,均为单侧眼睛非缺血型BRVO。将20只患眼纳入A组,20只对侧眼纳入B组。采用光学相干断层扫描血流成像(OCTA)技术测定视网膜脉络膜血流密度,采用增强深部成像(EDI)-OCT技术测定脉络膜厚度。比较两组的脉络膜厚度、视网膜脉络膜血流密度及最佳矫正视力(BCVA);分析BCVA与脉络膜厚度及视网膜脉络膜血流密度的相关性。结果A组中央脉络膜厚度、中心凹上、下方4.5 mm脉络膜厚度均厚于B组,差异具有统计学意义(P<0.05)。A组LogMAR BCVA高于B组,差异具有统计学意义(P<0.05)。A组、B组BCVA与脉络膜厚度呈负相关,与视网膜脉络膜血流密度呈低负相关(P<0.05)。结论BRVO患者的脉络膜厚度、视网膜脉络膜血流密度与患者视力预后紧密相关,OCTA技术在BRVO的诊疗中具有一定的意义。     

Increased serum levels of leptin in retinal vein occlusion

Retinal vein occlusion is an important cause of visual loss. Several ocular and systemic conditions have been reported for retinal vein occlusion. The pathogenesis of thrombus formation in the retinal vein, which results in retinal vein occlusion, is unclear. The aim of this study was to investigate the correlation between increased serum leptin levels and the occurrence of retinal vein occlusion (RVO). The study group consisted of 40 patients with RVO (58.1 +/- 6 years old; 17 males and 23 females): 15 patients with central RVO, 23 with branch RVO, and 2 with hemispheric RVO. The patients who had any ocular or systemic pathology were not included in the study. The control group consisted of 40 healthy individuals of similar gender, age, date and type of health survey, and geographic region. The blood samples of the RVO patients (n = 40) and controls (n = 40) were obtained antecubitally. Leptin levels were measured by an enzyme-linked immunosorbent assay (ELISA) method, and Student's t-test was used to determine differences between the groups. The mean serum leptin levels were 12.5 +/- 1.64 ng/ml in patients with RVO and 8.4 +/- 1.22 ng/ml in the control subjects; namely, the mean serum leptin levels were significantly higher in the patients with RVO (p < 0.001). These results suggest that leptin may be involved in the pathogenesis of venous thrombosis in the retina probably through its effects on homeostasis of the vessel wall.     

Management of macular edema secondary to central retinal vein occlusion: an evidence-based

Retinal vein occlusions are common retinal vascular disorders with the potential for significant vision-related morbidity. Retinal vein occlusions are classified as either branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO), or hemiretinal vein occlusion (HRVO) based on the specific occlusion site. The most common cause of decreased vision in patients afflicted with BRVO is the accumulation of fluid within the macula (macular edema). The Branch Vein Occlusion Study (BVOS) demonstrated the efficacy of grid laser photocoagulation in the treatment of BRVO-related macular edema. After publication of that report, grid laser became the standard of care for decreased vision due to BRVO-associated macular edema in patients similar to those enrolled in the BVOS. However, several recent major randomized, controlled clinical trials have investigated new therapeutic modalities for the treatment of decreased vision due to macular edema secondary to BRVO. This article aims to provide insight into current evidence-based approaches to management of macular edema secondary to BRVO. A companion article reviews approaches for management of macular edema secondary to CRVO.     

Management of macular edema secondary to branch retinal vein occlusion: an evidence-based update

Retinal vein occlusions are common retinal vascular disorders with the potential for significant vision-related morbidity. Retinal vein occlusions are classified as either branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO), or hemiretinal vein occlusion (HRVO) based on the specific occlusion site. The most common cause of decreased vision in patients afflicted with BRVO is the accumulation of fluid within the macula (macular edema). The Branch Vein Occlusion Study (BVOS) demonstrated the efficacy of grid laser photocoagulation in the treatment of BRVO-related macular edema. After publication of that report, grid laser became the standard of care for decreased vision due to BRVO-associated macular edema in patients similar to those enrolled in the BVOS. However, several recent major randomized, controlled clinical trials have investigated new therapeutic modalities for the treatment of decreased vision due to macular edema secondary to BRVO. This article aims to provide insight into current evidence-based approaches to management of macular edema secondary to BRVO. A companion article reviews approaches for management of macular edema secondary to CRVO.     

尿毒症患者血浆同型半胱氨酸及其相关因素的研究

目的　探讨尿毒症患者血浆同型半胱氨酸 (Hcy)的临床意义及其相关因素。方法　分别采用快速高压液相微柱层析法和Immlite全自动化学发光免疫分析仪测定 32例正常人和 32例尿毒症患者血液透析前后的血浆总Hcy和叶酸、维生素B12 浓度。结果　血液透析后血浆Hcy与叶酸较血液透析前明显下降 (P<0 .0 1) ,前者显著高于正常人 (P <0 .0 1) ,后者与正常值比较 ,均无显著差异 (P >0 .0 5 ) ;血液透析前叶酸与Hcy存在明显负相关 ,血浆维生素B12 与Hcy无显著相关性。内瘘堵塞组与非堵塞组比较 :血浆Hcy明显升高(P <0 .0 1) ;叶酸显著降低 (P <0 .0 5 )。结论　所有血液透析患者均存在高Hcy血症 ,可能是血液透析患者内瘘栓塞的危险因素之一。高Hcy血症的形成可能与叶酸相对缺乏有关