CAJ | 학술논문

目的观察糖尿病性视网膜病变玻璃体切除术后视网膜中央动脉阻塞的临床表现及预后.方法收集2012年6月至2014年3月在唐山市眼科医院视网膜中央动脉阻塞(CRAO)患者10例(10只眼),所有患者均有糖尿病性视网膜病变玻璃体切除术病史;观察视力、眼压、眼前节及眼底的表现,并进行眼底荧光血管造影(FFA)及光学相关断层扫描(OCT)检查;所有患者均给予常规抢救治疗.结果 10例患者均表现为视力突然明显下降;10例患者均出现视网膜动脉显著狭窄;5例部分血管闭塞;2例表现为典型的CRAO眼底改变(后极部视网膜灰白水肿,黄斑区樱桃红色).FFA检查:提示所有患者视网膜中央动脉无灌注或充盈迟缓;OCT图像表现为8例黄斑区视网膜厚度增加,光感受器暗区增宽,其中4例合并黄斑囊样水肿,2例黄斑萎缩变薄.9例患者在20天内出现新生血管性青光眼.结论糖尿病性视网膜病变玻璃体切除术后出现的视网膜中央动脉阻塞的临床表现不典型,FFA是诊断的金标准;常规抢救治疗无效,预后极差.
목적 관찰당뇨병성시망막병변파리체절제술후시망막중앙동맥조새적림상표현급예후.방법 수집2012년6월지2014년3월재당산시안과의원시망막중앙동맥조새(CRAO)환자10례(10지안),소유환자균유당뇨병성시망막병변파리체절제술병사;관찰시력、안압、안전절급안저적표현,병진행안저형광혈관조영(FFA)급광학상관단층소묘(OCT)검사;소유환자균급여상규창구치료.결과 10례환자균표현위시력돌연명현하강;10례환자균출현시망막동맥현저협착;5례부분혈관폐새;2례표현위전형적CRAO안저개변(후겁부시망막회백수종,황반구앵도홍색).FFA검사:제시소유환자시망막중앙동맥무관주혹충영지완;OCT도상표현위8례황반구시망막후도증가,광감수기암구증관,기중4례합병황반낭양수종,2례황반위축변박.9례환자재20천내출현신생혈관성청광안.결론 당뇨병성시망막병변파리체절제술후출현적시망막중앙동맥조새적림상표현불전형,FFA시진단적금표준;상규창구치료무효,예후겁차.
Objective To observe diabetic retinopathy central retinal artery occlusion after vitrectomy of clinical manifestation and prognosis.Methods Collected 10 patients with central retinal artery occlusion (10 eyes),and all patients had a history of diabetic retinopathy vitrectomy.The performance of vision,intraocular pressure,and the front section and fundus were observed.Also,the fundus fluorescence angiography (FFA) and optical coherence tomography (OCT) were commenced afterward.All patients were given conventional rescue treatment.Result All of the 10 patients exhibited an abrupt apparent drop of vision.Moreover,10 cases of patients all revealed retinal artery stenosis,with 5 cases of vascular occlusion.Furthermore,2 cases of patients performed typical fundus changes (the deepest part of rear retina exhibited gray colored edema and the muscular area presented cherry red).FFA examination:intimate all patients when central retinal artery suffer perfusion or delayed filling.OCT image:8 cases of retinal thickness increase,the photoreceptor dark zone broadening,including 4 cases of merger macular edema capsule sample,2 cases of macular atrophy thinning; 9 cases of patients with neo-vascular glaucoma in 20 days.Conclusions Diabetic retinopathy of central retinal artery occlusion after vitrectomy is atypical according to clinical manifestations,and FFA is the ideal standard of diagnosis; Conventional salvage treatment is invalid,the prognosis is poor.