视网膜黄斑分支静脉阻塞病变与视力预后关系的研究

目的探讨视网膜黄斑分支静脉阻塞(MBRVO)的部位、面积和黄斑中心凹毛细血管拱环破坏程度等因素对视力预后的影响和MBRVO患者黄斑中心凹无血管区(FAZ)面积的改变。方法分析荧光素眼底血管造影(FFA)检查确诊的27例27只眼的MBRVO部位、黄斑中心凹毛细血管拱环破坏程度和阻塞面积与视力恢复的关系及FAZ面积,用18例正常对照者FAZ面积的资料进行对比分析。结果27例MBRVO发生于黄斑上支者17只眼,占63%,平均阻塞面积为(16±10)mm2,平均视力0.32±0.28。黄斑下支者10只眼,占37%,平均阻塞面积为(12±10)mm2,平均视力0.37±0.20。黄斑上支与下支两组间视力恢复和阻塞面积差异无统计学意义(P>0.05)。拱环破坏≥1/2和<1/2两组间视力比较差异有统计学意义(P<0.05),面积比较差异无统计学意义(P>0.05)。27只眼阻塞面积平均值为(15±10)mm2,≥15mm2者10只眼,<15mm2者17只眼,视力在大于均值组与小于均值组的比较中差异无统计学意义(P>0.05)。MBRVO患者的FAZ面积明显大于正常人FAZ面积(P<0.05)。结论拱环破坏的范围是决定MBRVO预后视力的重要标准,MBRVO的FAZ面积比正常人的FAZ面积明显扩大。

The relationship between macular branch retinal vein occlusion and the prognosis of visual acuity

Objective To look at the impacts of dimension and location of macular branch retinal vein occlusion (MBRVO) and perifoveal capillary ring damage on the prognosis of visual acuity,and to investigate the changes in size of foveal avascular zone(FAZ)in MBRVO patients. Methods Data on 27 eyes of 27patients with ophthalmoscopy and fluorescein angiography diagnosed MBRVO,were retrospectively studied,including the location and dimension of lesions,severity of perifoveal capillary ring damage,visual acuity outcomes and sizes of FAZ. The sizes of FAZ in these patients were compared with data from 18 healthy controls. Results Of 27 patients,superior MBRVO occurred in 17 eyes (63%),with mean occlusion area of (16±10)mm2 and mean visual acuity of 0.32±0.28,while inferior MBRVO occurred in 10 eyes (37%),with mean occlusion area of (12±10)mm2 and mean visual acuity of 0.37±0.20. There were no significant differences in visual acuity and areas of occlusion between patients with superior MBRVO and inferior MBRVO (P>0.05). Between patients with ≥1/2 and <1/2 damage of perifoveal capillary ring,significant difference was observe in visual acuity (P<0.05) but not in area of FAZ (P>0.05). The mean area of vein occlusion in 27 eyes was (15±10)mm2,with ≥15 mm2 occlusion in 10 eyes vs <15 mm2 occlusion in 17. Visual acuity did not differ between patients with occlusions larger and smaller than mean area (P>0.05). The FAZ area in MBRVO was obviously larger than that of healthy controls. Conclusion The prognosis of visual acuity in the patients with MBRVO depends on the dimension of damaged capillary ring rather than the area of occlusion. The size of FAZ in MBRVO appears obviously larger than normal.