大动脉炎患者的荧光素眼底血管造影分析

目的分析大动脉炎患者荧光素眼底血管造影（FFA）的特点。方法回顾性分析12例大动脉炎患者FFA特点及其相关临床资料。结果12例患者中慢性缺血性眼底改变9例（15眼），5例臂-视网膜循环时间延长，时间为（19．20±2．95）s，5例视网膜循环时间延长，时间为（10．62±6．15）s；2例（2眼）视盘周围动静脉花冠状吻合，4例（6眼）黄斑拱环结构不完整；8例（14眼）可见视网膜毛细血管扩张及微动脉瘤。视网膜、视盘新生血管各1例（2眼）。高血压性眼底改变3例（4眼），主要表现为小动脉变细，动脉硬化，出血、棉絮斑、黄斑区硬性渗出。12例患者中有10例为内科确诊大动脉炎后眼科会诊，2例首诊于眼科，行FFA检查后诊断为大动脉炎。结论大动脉炎患者的视网膜改变主要有慢性缺血性和高血压性2种。了解大动脉炎视网膜病变的FFA特征有助于部分大动脉炎的临床诊断。

Clinical analysis of fundus fluorescein angiography in Takayasu arteritis

Background Takayasu arteritis is a non specificity inflammation of aorta and its branch.The incidence of Takayasu arteritis is low and its ocular secondary disease is rare.The correct diagnosis of Takayasu arteritis is very important for its early treatment in clinic.Objective This study is to analyze the fundus findings and characteristic of fundus fluorescein angiography (FFA) of Takayasu retinopathy.Methods The FFA and clinical data of 12 patients (24 eyes) with Takayasu arteritis were retrospectively reviewed.Written informed consent was obtained from all the patients before and initiation of any study protocol.Results In 12 patients,chronic ischemic retinopathy was found in 15 eyes of 9 patients.The arm to retina circulation time(A RCT) prolonged to (19.20±2.95) s in 5 eyes,and the retinal circulation time (RCT) delayed to 10.62±6.15 s in 5 eyes.Peripapillary arteriovenous anastomosis was found in 2 eyes of 2 patients.Macular arch ring was incomplete in 6 eyes of 4 patients.Eight patients (14 eyes) had telangiectasis and microaneurysm,and 2 eyes of 2 patients presented neovascularization on the disc or elsewhere.In 12 patients,hypertensive retinopathy was found in 4 eyes of 3 patients,showing narrow retinal artery,arteriosclerosis,hemorrhage,cotton wool spots and hard exudates.Ten patients were diagnosed as Takayasu arteritis before FFA examination,and 2 patients were determinedly diagnosed after FFA was performed.Conclusion The main features of Takayasu retinopathy are hypertensive retinopathy and chronic ischemic retinopathy.It is important for ophthalmologist to correctly recognize the clinical features of TA.