视网膜中央静脉阻塞的临床特点及诊断和治疗(附1例报告)Clinical characteristics, diagnosis and treatment of central retinal vein occlusion in patients (a case report)
胡艳滨;高军;高惠娟;
摘要(Abstract):
目的总结视网膜中央静脉阻塞(CRVO)的临床特点、诊断方法和治疗方法。方法回顾性分析1例中青年CRVO患者的临床资料。结果患者因"右眼前闪光感,可见条纹样黑影1周"就诊;双眼矫正视力1.0;眼底照相显示右眼视盘充血、边界模糊不清,视网膜静脉迂曲扩张明显,局部呈腊肠样改变,视网膜散在点片状出血,黄斑区无水肿。眼底荧光血管造影(FFA)检查符合"右眼CRVO、右眼视盘水肿",进而诊断为CRVO。给予口服及球旁注射激素治疗,辅以活血化瘀、改善微循环、营养神经药物,治疗后复查眼底照相以及光学相干断层扫描血管成像(OCTA)检查显示视盘上、下方侧支血管逐渐形成,侧支血管形成初期较为细小,后逐渐增粗、走形较为迂曲,并呈单支走形,尤其下方侧支呈现多圈状,伴随侧支血管的出现,视网膜静脉迂曲扩张状态以及视盘水肿逐渐缓解,并完全恢复,病程进展中未出现黄斑水肿,视力无下降,闪光感逐渐恢复,条纹样黑影消失,随访11个月无复发。结论 CRVO的临床特点为视盘充血、边界模糊不清,视网膜静脉迂曲扩张明显,局部呈腊肠样改变,视网膜散在点片状出血,黄斑区无水肿;眼底照相、FFA检查可以确诊;口服及球旁激素注射治疗后视盘侧支血管逐渐形成,并在OCTA中呈像清晰,表现为走形迂曲的单根血管,可呈多圈状,患者预后良好。
关键词(KeyWords): 视网膜中央静脉阻塞;侧支血管;眼底照相;光学相干断层扫描血管成像
基金项目(Foundation):
作者(Author): 胡艳滨;高军;高惠娟;
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参考文献(References):
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