中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2009年
12期
1080-1083
,共4页
王艳玲%赵露%黄映湘%冯雪%李明铭
王豔玲%趙露%黃映湘%馮雪%李明銘
왕염령%조로%황영상%풍설%리명명
眼表现%缺血%颈动脉狭窄%荧光素血管造影术%超声检查%多普勒%经颅
眼錶現%缺血%頸動脈狹窄%熒光素血管造影術%超聲檢查%多普勒%經顱
안표현%결혈%경동맥협착%형광소혈관조영술%초성검사%다보륵%경로
Eye manifestations%Ischemia%Carotid stenosis%Fluorescein angiography%Ultrasonography%transcranial doppler
目的 探讨眼缺血综合征患者的临床特征.方法 回顾性系列病例研究.收集2008年2月至2009年4月收治的10例(12只眼)眼缺血综合征患者的临床资料,包括性别、年龄、全身病史、最佳矫正视力和眼前节、眼底、荧光素眼底血管造影(FFA)、经颅超声多普勒(TCD)、数字减影血管造影(DSA)等检查结果.结果 10例(12只眼)眼缺血综合征患者中,男性6例(6只眼),女性4例(6只眼);年龄55～66岁,平均59岁.患者均伴有心血管和(或)脑血管疾病.最佳矫正视力为手动至1.0,虹膜新生血管5只眼,眼压超过21 mm Hg(1 mm Hg=0.133 kPa)者3只眼.眼底表现为动脉细,静脉不同程度扩张但不迂曲,点片状视网膜出血和棉絮斑,视乳头水肿和新生血管,黄斑呈不典型樱桃红色.所有患者均行TCD检查,可见颈内动脉不同程度狭窄或闭塞.9例患者行FFA检查,均表现为动脉"前锋"现象,臂-视网膜循环时间、视网膜循环时间及脉络膜循环时间延长.所有患者均给予扩血管及改善微循环药物治疗,视力不同程度提高.虹膜新生血管5只眼中,2只眼行视网膜光凝,虹膜新生血管消退.继发新生血管性青光眼3只眼中,1只眼行睫状体冷冻术;1只眼行视网膜光凝及颈内动脉支架植入术,术后新牛血管消退,眼压控制正常;1只眼行颈内动脉支架植入术,术后眼压正常.4例行DSA检查,3例行颈内动脉支架植入术,1例行锁骨下动脉支架植入术,1例行颈内动脉内膜剥离术.结论 由于眼缺血综合征患者的缺血严重程度不一,眼部表现复杂多样,需要眼科医师联合神经内、外科医师共同诊治.
目的 探討眼缺血綜閤徵患者的臨床特徵.方法 迴顧性繫列病例研究.收集2008年2月至2009年4月收治的10例(12隻眼)眼缺血綜閤徵患者的臨床資料,包括性彆、年齡、全身病史、最佳矯正視力和眼前節、眼底、熒光素眼底血管造影(FFA)、經顱超聲多普勒(TCD)、數字減影血管造影(DSA)等檢查結果.結果 10例(12隻眼)眼缺血綜閤徵患者中,男性6例(6隻眼),女性4例(6隻眼);年齡55～66歲,平均59歲.患者均伴有心血管和(或)腦血管疾病.最佳矯正視力為手動至1.0,虹膜新生血管5隻眼,眼壓超過21 mm Hg(1 mm Hg=0.133 kPa)者3隻眼.眼底錶現為動脈細,靜脈不同程度擴張但不迂麯,點片狀視網膜齣血和棉絮斑,視乳頭水腫和新生血管,黃斑呈不典型櫻桃紅色.所有患者均行TCD檢查,可見頸內動脈不同程度狹窄或閉塞.9例患者行FFA檢查,均錶現為動脈"前鋒"現象,臂-視網膜循環時間、視網膜循環時間及脈絡膜循環時間延長.所有患者均給予擴血管及改善微循環藥物治療,視力不同程度提高.虹膜新生血管5隻眼中,2隻眼行視網膜光凝,虹膜新生血管消退.繼髮新生血管性青光眼3隻眼中,1隻眼行睫狀體冷凍術;1隻眼行視網膜光凝及頸內動脈支架植入術,術後新牛血管消退,眼壓控製正常;1隻眼行頸內動脈支架植入術,術後眼壓正常.4例行DSA檢查,3例行頸內動脈支架植入術,1例行鎖骨下動脈支架植入術,1例行頸內動脈內膜剝離術.結論 由于眼缺血綜閤徵患者的缺血嚴重程度不一,眼部錶現複雜多樣,需要眼科醫師聯閤神經內、外科醫師共同診治.
목적 탐토안결혈종합정환자적림상특정.방법 회고성계렬병례연구.수집2008년2월지2009년4월수치적10례(12지안)안결혈종합정환자적림상자료,포괄성별、년령、전신병사、최가교정시력화안전절、안저、형광소안저혈관조영(FFA)、경로초성다보륵(TCD)、수자감영혈관조영(DSA)등검사결과.결과 10례(12지안)안결혈종합정환자중,남성6례(6지안),녀성4례(6지안);년령55～66세,평균59세.환자균반유심혈관화(혹)뇌혈관질병.최가교정시력위수동지1.0,홍막신생혈관5지안,안압초과21 mm Hg(1 mm Hg=0.133 kPa)자3지안.안저표현위동맥세,정맥불동정도확장단불우곡,점편상시망막출혈화면서반,시유두수종화신생혈관,황반정불전형앵도홍색.소유환자균행TCD검사,가견경내동맥불동정도협착혹폐새.9례환자행FFA검사,균표현위동맥"전봉"현상,비-시망막순배시간、시망막순배시간급맥락막순배시간연장.소유환자균급여확혈관급개선미순배약물치료,시력불동정도제고.홍막신생혈관5지안중,2지안행시망막광응,홍막신생혈관소퇴.계발신생혈관성청광안3지안중,1지안행첩상체냉동술;1지안행시망막광응급경내동맥지가식입술,술후신우혈관소퇴,안압공제정상;1지안행경내동맥지가식입술,술후안압정상.4례행DSA검사,3례행경내동맥지가식입술,1례행쇄골하동맥지가식입술,1례행경내동맥내막박리술.결론 유우안결혈종합정환자적결혈엄중정도불일,안부표현복잡다양,수요안과의사연합신경내、외과의사공동진치.
Objective To study clinical characteristics of ocular ischemic syndrome (OIS).Methods Retrospective study.Data,including sex,age,systemic diseases,best corrected visual acuity,anterior segment,fundus,fundus fluorescence angiography (FFA),transcranial Doppler (TCD) and digital subtraction angiography (DSA),were collected from 10 patients (12 eyes) with ocular ischemic syndrome from February 2008 to April 2009.Results The mean age was 59 years.There were six males and four females.All patients were combined with heart and/or cerebrovascular diseases.Best corrected visual acuity ranged from hand movement to 1.0.Neovascularization of the iris appeared in 5 eyes.Intraocular pressure over 21 mm Hg (1 mm Hg=0.133 kPa) was present in 3 eyes.Fundus examination showed narrow retinal arteries,dilated but not tortuous veins,fleck-shaped hemorrhage of the retina,cotton-wool exudates,optic disc edema,optic disc neovascularization,and atypical macular cherry-red spots.TCD showed stenosis of internal carotid artery at different degrees.FFA was performed in 9 patients which showed artery front,prolonged arm-retinal circulation time,retinal circulation time and choroid circulation time.All patients accepted vasodilation and microcirculation improving treatments.Visual acuity was improved at different degrees.One patient (2 eyes) with iris neovascularization was treated with retinal photocoagulation and the neovascularization disappeared after the treatment.There were 3 patients (3 eyes) had neovascular glaucoma.One patient was treated by ciliary cryotherapy.One patient was treated by retinal photocoagulation and internal carotid artery stent implantation and one were treated by internal carotid artery stent implantation.Four patients were examined by DSA.Internal carotid artery stent implantation was performed in 3 patients,subclavian artery stent implantation was performed in one patient and internal carotid artery intima decollement was performed in one patient.Conclusions Clinical manifestations of ocular ischemic syndrome patients are complicated which are depended on the different extents of ischemia.The management of ocular ischemic syndrome requires the collaboration of ophthalmologists,neurophysicians and neurosurgeons.
