41例糖尿病视网膜病变合并视网膜静脉阻塞的临床及眼底病变分析

目的 分析糖尿病视网膜病变（DR）合并视网膜静脉阻塞（RVO）的眼底特征和荧光素眼底血管造影（FFA）的图像特征。方法 回顾分析眼科门诊行FFA检查的DR合并RVO患者41例45眼的眼底图像特征及相关临床资料。结果 41例DR合并RVO的患者中．双眼同时发病有4例8只眼．其余皆为单眼，其中以视网膜中央静脉阻塞（CRVO）最多，有29只眼．其次为颞上分支静脉阻塞．有7只眼．其它分吏静脉阻塞有9只眼。FFA表现为：静脉阻塞区网膜有大量神经纤维层出血．相应黄斑区荧光渗漏．掩盖了此眼DR的改变．对侧眼可见DR不同级别的改变或无DR改变。所观察病例中有1只眼同时合并动、静脉阻塞．FFA表现为：静脉阻塞区网膜有大量出血．动脉阻塞区网膜苍白，动脉充盈延迟。结论 DR合并RVO的临床及眼底改变有其特殊性．应与单发的DR或RVO鉴别。

Fundus Observation of Diabetic Retinopathy Combined with Retina Vein Occlusion in 41 Patients

Objective To observe the characteristics of fundus images and fluorescin angiography(FFA) in diabetic retinopathy(DR) combined with retinal vein occlusion(RVO).Methods The clinical data of FFA and other related information of 41 patients,who were diagnosed as DR combined with RVO were retrospectively analyzed.Results In the 41 cases of DR combined with RVO,bilateral lesions occurred in 4 patients(8 eyes),and the remaining cases had the unilateral lesions. CRVO was the most predominant(29 eyes),followed by temporal upper branch RVO (7 eyes),other branch RVO(9 eyes).FFA showed that extensive hemorrhage was seen at the vein occlusion area,and disc and fovea of macula was involved with fluorescein leakage,at the same time,they covered DR change of this eye.The apposite eye had DR changes to varying degrees or no DR change.There was a special one eye showing the occlusion of branch vein and artery at the same time.FFA showed extensive hemorrhage was located in the vein occlusion areas,and a small ivory-white field appeared around the fields of artery occlusion and the perfusion of artery was delayed.Conclusion The clinical and fundus changes of DR combined with RVO were of characteristics and should be distinguished with single DR or RVO.