Johnson T Mark, Vaughn Christopher W, Glaser Bert M
The National Retina Institute, Chevy Chase, MD 20815, USA.
Can J Ophthalmol. 2006 Oct;41(5):600-2. doi: 10.1139/i06-056.
Branch retinal vein occlusion (BRVO) is believed to arise at arteriovenous crossing sites. Surgical dissection of the arteriovenous sheath has been proposed as a treatment option, yet induction of a posterior vitreous detachment may be as important in obtaining a successful surgical outcome, suggesting that vitreoretinal traction may play a role in the development of BRVO. A retrospective review of 3 patients presenting with clinical features of BRVO and evidence of vitreoretinal traction at the occlusion site was conducted.
All patients presented with mild vitreous hemorrhage. Intraretinal hemorrhages were distributed in an unusual linear pattern along the involved venous segment, suggesting the presence of vitreoretinal traction. Fluorescein angiography demonstrated blocked fluorescence secondary to hemorrhage with delay of venous flow at the avulsion site. Partial avulsion of the involved venous segment was evident on clinical examination, B-scan ultrasound, or optical coherence tomography. Vitreoretinal traction may contribute to the pathogenesis of BRVO in some patients.
视网膜分支静脉阻塞(BRVO)被认为起源于动静脉交叉处。有人提出对动静脉鞘进行手术剥离作为一种治疗选择,但诱导后玻璃体脱离在获得成功的手术结果中可能同样重要,这表明玻璃体视网膜牵拉可能在BRVO的发生发展中起作用。对3例表现出BRVO临床特征且在阻塞部位有玻璃体视网膜牵拉证据的患者进行了回顾性研究。
所有患者均出现轻度玻璃体出血。视网膜内出血沿受累静脉段呈不寻常的线性分布,提示存在玻璃体视网膜牵拉。荧光素血管造影显示出血导致荧光素阻塞,在撕脱部位静脉血流延迟。在临床检查、B超或光学相干断层扫描中可见受累静脉段部分撕脱。玻璃体视网膜牵拉可能在某些患者BRVO的发病机制中起作用。