Archer D
Department of Ophthalmology, Queen's University Belfast, Royal Victoria Hospital, Northern Ireland.
Yan Ke Xue Bao. 1992 Mar;8(1):40-4.
The natural course of Branch Retinal Vein Occlusion is determined by the site and completeness of the occlusion, the integrity of arterial perfusion to the affected sector and the efficiency of the developing collateral circulation. Most patients with tributary vein occlusion have some capillary fall out and microvascular incompetence in the distribution of the affected retina and vision is significantly compromised in over 50% of patients who have either chronic macular oedema or ischemia involving the perifoveolar arcades. Retinal and capillary vasoproliferation with or without intraretinal or preretinal membrane formation are common sequelae, where inner retinal ischemia is extensive and vitreous hemorrhage is often a distinct threat to vision. Treatment of the sequelae of vein occlusion are largely centered on laser photocoagulation to diseased retina to limit fluid accumulation and abolish preretinal and papillary neovascularization. Vitrectomy and retinal detachment procedures are occasionally required in patients with uncontrolled vitreous hemorrhage and retinal membrane formation which threatens the integrity of the macula. A small proportion of patients with vein occlusion subsequent to vasculitis require medical therapy.
视网膜分支静脉阻塞的自然病程取决于阻塞的部位和完整性、受累区域动脉灌注的完整性以及侧支循环形成的效率。大多数分支静脉阻塞患者在受累视网膜分布区域存在一定程度的毛细血管丧失和微血管功能不全，超过50%患有慢性黄斑水肿或累及黄斑周围血管弓缺血的患者视力会受到显著损害。视网膜和毛细血管血管增生伴或不伴视网膜内或视网膜前膜形成是常见的后遗症，其中视网膜内层缺血广泛，玻璃体积血往往对视力构成明显威胁。静脉阻塞后遗症的治疗主要集中在对病变视网膜进行激光光凝，以限制液体蓄积并消除视网膜前和视乳头新生血管形成。对于玻璃体积血无法控制且视网膜膜形成威胁黄斑完整性的患者，偶尔需要进行玻璃体切除术和视网膜脱离手术。一小部分血管炎继发静脉阻塞的患者需要药物治疗。
