Rumelt Shimon, Karatas Muge, Pikkel Joseph, Majlin Michael, Ophir Avinoam
Department of Ophthalmology, Western Galilee, Nahariya Medical Center, Nahariya, Israel.
Arch Ophthalmol. 2003 Aug;121(8):1093-7. doi: 10.1001/archopht.121.8.1093.
To describe the association between ischemic central retinal vein occlusion (CRVO) and the development of optic disc (vitreopapillary) traction, as verified by optical coherence tomography (OCT).
In a prospective, noncomparative, observational patient series, 3 women aged 51 to 64 years developed an ischemic type of CRVO. One patient underwent cannulation of the central retinal vein with injection of a tissue plasminogen activator. In each eye, the contour of the optic nerve head could not be accurately detected because of overlying fibrous tissue. Each patient underwent OCT examination 6 to 10 months (average, 8.3 months) after the occlusive event.
Optic disc traction was found by OCT in the 3 patients. In each, the disc was elevated, associated with either incomplete posterior vitreous detachment (2 eyes) or vitreopapillary fibrous membrane (1 eye). Secondary peripapillary retinal traction and macular or retinal detachment developed ("optic disc traction syndrome"). These findings were less marked, or not evident, on both clinical examination and ocular ultrasonography.
Optic disc traction and secondary localized retinal detachment can develop after ischemic CRVO and may contribute to the poor visual acuity. This syndrome should merit special attention before surgery for CRVO is planned. The use of OCT was helpful to diagnose this syndrome.
描述经光学相干断层扫描（OCT）证实的缺血性视网膜中央静脉阻塞（CRVO）与视盘（玻璃体视乳头）牵引形成之间的关联。
在一个前瞻性、非对照、观察性患者系列中，3名年龄在51至64岁的女性发生了缺血型CRVO。1例患者接受了视网膜中央静脉插管并注射组织纤溶酶原激活剂。由于覆盖的纤维组织，每只眼睛的视神经乳头轮廓均无法准确检测。每位患者在闭塞事件发生后6至10个月（平均8.3个月）接受了OCT检查。
3例患者经OCT检查发现存在视盘牵引。在每例患者中，视盘均有抬高，与不完全性玻璃体后脱离（2只眼）或玻璃体视乳头纤维膜（1只眼）相关。继而出现视乳头周围视网膜牵引以及黄斑或视网膜脱离（“视盘牵引综合征”）。这些表现在临床检查和眼部超声检查中不明显或未显现。
缺血性CRVO后可出现视盘牵引和继发性局限性视网膜脱离，这可能是视力不佳的原因。在计划对CRVO进行手术前，该综合征应引起特别关注。OCT的应用有助于诊断该综合征。
