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目的探讨老年人非外伤性玻璃体大量积血的病因。方法对非外伤性玻璃体大量积血的老年患者81例83只眼的病因资料进行总结分析。结果81例中,视网膜静脉阻塞导致玻璃体大量积血的患者最多,33例(40.7%);其次,为增殖型糖尿病性视网膜病变患者31例(38.3%);渗出型老年性黄斑变性患者10例(12.4%)。视网膜静脉阻塞患者中,玻璃体大量积血迟发于视网膜静脉阻塞的时间间隔≥3个月为21只眼(63.6%),眼底检查均发现新生血管;<3个月者为9只眼(27.3%),眼底检查未发现新生血管。结论视网膜静脉阻塞、增殖型糖尿病性视网膜病变和渗出型老年性黄斑变性是老年人非外伤性玻璃体大量积血的主要病因。眼底新生血管的形成、破裂和出血是老年人非外伤性玻璃体大量积血的主要原因。
Objective To explore the etiology of massive traumatic hemorrhage of non-traumatic vitreous in the elderly. Methods The etiological data of 83 eyes of 81 elderly patients with non-traumatic vitreous mass hemorrhage were analyzed. Results Among the 81 cases, retinal vein occlusion caused the most patients with massive vitreous hemorrhage in 33 patients (40.7%), followed by 31 patients (38.3%) with proliferative diabetic retinopathy, exudative age-related macular degeneration Example (12.4%). Among the patients with retinal vein occlusion, the mass of hematoma in the vitreous was delayed to be 21 eyes (63.6%) at retinal vein occlusion ≥3 months. The neovascularization was found in the fundus examination and in 9 eyes (27.3 <3 months) %), Retinal examination found no new blood vessels. Conclusions Retinal vein occlusion, proliferative diabetic retinopathy and exudative age-related macular degeneration are the major causes of massive non-traumatic vitreous hemorrhage in the elderly. Ocular fundus neovascularization, rupture and hemorrhage are the main causes of massive hemorrhage of the non-traumatic vitreous in the elderly.