Duker J S, Cohen M S, Brown G C, Sergott R C, McNamara J A
Retina Service, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA.
Retina. 1990;10(2):105-12. doi: 10.1097/00006982-199004000-00003.
We observed seven patients with the unusual combination of a central retinal vein obstruction in conjunction with a simultaneous branch retinal artery obstruction. The patients presented with sectoral retinal whitening, as well as diffuse peripapillary and superficial retinal hemorrhages. In five of the seven patients, the retinal hemorrhages appeared most florid in the territory of the obstructed arteriole, resulting initially in the consideration that these cases represented a combined branch retinal artery and branch retinal vein obstruction. In all cases, however, the presence of dilated, tortuous veins with diffuse retinal hemorrhages, in addition to generalized delay in arteriovenous transit on fluorescein angiography, localized the venous blockage to the central retinal vein. No intra-arterial retinal emboli were visualized. Initially, five of the seven patients suffered markedly diminished visual function; although visual acuity returned to near normal in all but two patients. In the two patients with non-resolving, markedly impaired visual acuity, neovascularization of the iris complicated the clinical course. Both of these patients were treated with panretinal photocoagulation, with resolution of the iris neovascularization. These seven patients highlight another variation of combined arterial and venous retinal vascular disease.
我们观察了7例视网膜中央静脉阻塞合并视网膜分支动脉阻塞这一罕见组合情况的患者。这些患者表现为视网膜扇形变白，以及视乳头周围和视网膜浅层弥漫性出血。在这7例患者中的5例中，视网膜出血在阻塞小动脉的区域最为明显，最初导致认为这些病例代表视网膜分支动脉和视网膜分支静脉联合阻塞。然而，在所有病例中，除了荧光素血管造影显示动静脉循环普遍延迟外，存在扩张、迂曲的静脉以及视网膜弥漫性出血，提示静脉阻塞位于视网膜中央静脉。未发现动脉内视网膜栓子。最初，7例患者中有5例视力明显下降；尽管除2例患者外，所有患者的视力均恢复至接近正常。在这2例视力未恢复且明显受损的患者中，虹膜新生血管使临床病程复杂化。这2例患者均接受了全视网膜光凝治疗，虹膜新生血管消退。这7例患者凸显了动静脉联合视网膜血管疾病的另一种变异情况。
