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目的观察视网膜分支静脉阻塞(BRVO)伴行的动脉变化及其对预后的影响。设计回顾性病例系列。研究对象黑龙江省医院121例(124眼)BRVO患者。方法观察不同病程的BRVO患者荧光素眼底血管造影(FFA)的影像资料,分析不同病程伴行的动脉变化对视网膜无灌注区的形成、新生血管的发生及视神经的影响。主要指标FFA图像中视网膜动脉管径及充盈时间等改变。结果早期患者64眼中,动脉管径扩张且荧光素渗漏严重者27眼(42.19%),其中19眼(70.37%)在病变晚期出现了超过7 PD的大片无灌注区,而动脉正常或受累轻微的37眼中仅7眼出现大片无灌注区(P<0.05)。所有患者中38眼(30.68%)病变晚期发生小动脉闭塞;18眼(14.52%)阻塞静脉与伴行动脉的远端出现一致性闭塞;5眼(4.03%)伴行动脉干不同程度闭塞。65眼(52.41%)出现大片毛细血管无灌注区,其中49眼(75.38%)发生视盘或视网膜新生血管,而与动脉有关的新生血管有16眼(43.24%)。结论 BRVO伴发的视网膜动脉受累(如早期患者动脉充盈延缓、管径扩张,晚期患者动脉管径缩窄、小动脉闭塞等)程度可作为早期判断有无无灌注区、识别发生新生血管高危眼以及对BRVO分型的参考指征。
Objective To observe the arterial changes associated with retinal branch vein occlusion (BRVO) and its effect on prognosis. Design retrospective case series. The subjects were 121 cases (124 eyes) of BRVO patients in Heilongjiang Provincial Hospital. Methods The images of fluorescein fundus angiography (FFA) in patients with BRVO at different stages of disease were observed. The formation of non-perfusion zone, the development of neovascularization and optic nerve in different retinopathy were analyzed. Main indicators FFA retinal artery diameter and filling time and other changes. Results Of the 64 eyes of early stage, 27 eyes (42.19%) had arterial diameter dilation and serious fluorescein leakage, of which 19 (70.37%) had large non-perfusion area more than 7 PD in the late stage of disease, while the normal or affected artery Only 7 eyes of 37 eyes had a large non-perfusion area (P <0.05). In all patients, 38 eyes (30.68%) developed occlusion of arterioles in late stage of disease; 18 eyes (14.52%) had consistent occlusion distal to obstructive and accessory arteries; 5 eyes (4.03%) had arterial occlusion of different degrees. In 65 eyes (52.41%), there were large areas of capillaries without perfusion. Among them, 49 eyes (75.38%) developed optic disc or retinal neovascularization, while arterial related neovascularization occurred in 16 eyes (43.24%). Conclusions The degree of retinal arterial involvement (such as delayed arterial filling, diameter expansion, arterial diameter narrowing, arteriolar occlusion, etc.) in patients with BRVO can be used as early judgment of whether there is no perfusion area to identify the high risk of neovascular As well as reference indications for BRVO typing.