视网膜分支静脉阻塞合并视网膜脱离的临床分析

目的 分析视网膜分支静脉阻塞(BRVO)合并视网膜脱离(RD)的临床特征及有效的治疗方法.方法 收集2004年11月至2007年10月治疗的有完整随访观察资料的18例(18只眼)BRVO合并RD的病例,采用常规三通道闭合式玻璃体切割手术,其中6例联合白内障超声乳化吸出术,合并黄斑裂孔的患眼行内界膜剥离,术后1、2周,1、2、3、6月随访,平均随访4.8月,观察患者的视力、眼底、眼压、玻璃体后脱离,术中术后并发症、及术后视网膜复位等情况.结果 全部病例于术中均发现裂孔,单个孔、多发孔各9例,孔源性视网膜脱离17例,牵引性视网膜脱离1例,黄斑孔5例,黄斑孔中合并黄斑囊样水肿1例,合并黄斑前膜2例.18例中发现纤维血管膜生长的15例,玻璃体不完全性后脱离粘连牵拉视网膜的12例,黄斑水肿6例,其中合并黄斑前膜2例.BRVO发生于颞上的6例,鼻上6例,上半侧3例,颞下2例,颢上合并颞下1例.18例中术后视力提高12例,视力稳定3例,视力下降3例,术后最佳矫正视力HM3例、0.1-0.39例、0.3以上6例.一次手术视网膜复位的16例,2例于硅油取出时发现局限性视网膜脱离,再次填充C3F8后视网膜复位.结论 视网膜分支静脉阻塞合并视网膜脱离的临床表现较复杂,术前眼底情况不明确,视网膜裂孔及多发性裂孔的发生率较高,多数病例玻璃体后脱离不完全粘连牵拉视网膜,且合并纤维血管膜的增生,玻璃体手术或联合手术是适合的治疗方法,可取得较好的临床疗效.

Branch retinal vein occlusion merger retinal detachment of the clinical features

Objective To analyze branch retinal vein occlusion(BRVO)merger of retinal detachment (RD)of the clinical features and appropriate treatment.Methods The hospital in November 2004 to October 2007 admission of a complete follow-up observations of 18 cases of 18 eyes BRVO RD merger cases,all patients were using conventional three-channel closed-vitrectomy,including six joint cataract Phacoemulsification surgery,The merger oftbe three macular hole in the membrane peeling line,after 2 weeks,1,2,3,6 month follow-up,An average of 4.8 months,the visual observation of patients,eyes,intraocular pressure,posterior vitreous detachment,after operation Complications after retinal reattachment,and so un.ResultsAll patients(18/18)were found in the hole,a single hole,more than all nine of the holes,and retinal detachment 17eyes,Traction retinal detachment one eye,Macular hole 5,macular hole in the merger cystoid macular edema one,before merger-related macular film 2.18 eyes found that the growth of fiber vascular membrane 15,vitreous detachment incomplete adhesion pull the retina 12,six of which merger-related macular macular edema before the film 2,BRVO occurred in temporal quadrant at the top of the six,Bite at the top quadrant six,three at the top of Half quadrant,the temporal bottom quadrant 2,temporal quadrant at the top merger of temporal bottom quadrant one.18 eyes of 12 improved eyesight,vision and stability 3 eyes,dropped three visiun.Afler the best vision correction HM 3 eyes,0.1 to 0.3 9,0.3 more than six,all cases of retinal surgery in a reduction of 16 eyes,two silicone oil removal was found in the limitations of retinal detachment,once again filled C3F8 after retinal reattachment.Conclusion The branch retinal vein occlusion (BRVO)merger of retinal detachment (RD)of the clinical manifestations more complicated,before the eyes of the situation is not clear,Retinal hole and multiple holes in the higher rate,the majority of cases of posterior vitreous detachment is not completely And adhesion retinal traction,and the combined fiber membrane vascular proliferation ,vitreous surgery or surgery is appropriate treatment,can get better clinical effect.