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目的 探讨视盘周围视网膜脉胳膜出血(peripapillary retinal choroid hemorrhage,PPRCH)的发病原因及临床特点、鉴别诊断和PPRCH患者视网膜新生血管的治疗。方法 对17例18眼PPRCH患者的临床表现及眼底荧光血管造影(fundus luorescein angiography,FFA)等临床资料作回顾性分析。结果 17例均为中度以下近视,平均年龄24岁,16例单眼发病。PPRCH分4种类型:4例视盘表面出血。6例(7眼)视盘出血伴PPRCH。4例PPRCH,3例PPRCH伴玻璃体出血,其中出血及新生血管波及黄斑1例。FFA显示PPRCH为遮蔽荧光,患者2周至6个月出血全部吸收,其中1例视网膜新生血管行激光治疗,半年后出血吸收。结论 根据临床及FFA表现,我们推测,PPRCH是视盘埋藏性玻璃疣的视网膜并发症。
Objective To investigate the etiology and clinical features of peripapillary retinal choroid hemorrhage (PPRCH), differential diagnosis and treatment of retinal neovascularization in patients with PPRCH. Methods Clinical data of 17 patients with PPRCH in 18 eyes and clinical data of fundus luorescein angiography (FFA) were analyzed retrospectively. Results 17 cases were moderate myopia, the average age was 24 years old, 16 cases of monocular disease. PPRCH divided into 4 types: 4 cases of optic disc surface bleeding. Six cases (7 eyes) of optic disc hemorrhage with PPRCH. 4 cases of PPRCH, 3 cases of PPRCH with vitreous hemorrhage, including bleeding and neovascularization in 1 case of macular. FFA showed PPRCH shading fluorescence, the patient 2 weeks to 6 months all the absorption of bleeding, including 1 case of retinal neovascularization laser treatment, six months after the absorption of bleeding. Conclusions Based on clinical and FFA findings, we hypothesize that PPRCH is a retinal complication of optic disc-embedded drusen.