Bartz-Schmidt K U, Schmitz-Valckenberg P
Augenabteilung, Krankenhaus Ev. Stift St. Martin, Koblenz, Bundesrepublik Deutschland.
Fortschr Ophthalmol. 1991;88(5):466-72.
In six eyes we found typical signs that could serve as criteria for the differentiation of ischemic from non-ischemic retinal branch vein occlusion. Perimetry showed a mean defect (in the affected area) of more than 10 dB in eyes with defects in the retinal nerve fiber layer in contrast with 5 dB on one eye without nerve fiber defects. Secondly, fluorescein angiography showed ischemic areas in all eyes examined with localized defects in the photographs of the retinal nerve fiber layer. Damage of the retinal nerve fiber layer was observed before capillary obliteration could be detected by fluorescein angiography. Thirdly, semiquantitative optic disc morphometry demonstrated that using the difference between pallor and excavation as the only sign in ascending optic atrophy is not always useful. Fourthly, photography of the retinal nerve fiber layer showed that there is no correlation between the extension of the ischemic area and the sector angle of the defect of the retinal nerve fiber layer. Photography of the retinal nerve fiber layer can differentiative ischemic from non-ischemic retinal branch vein occlusion because of the qualitative detection of localized retinal nerve fiber layer defects. Consequently, this method is not only of great clinical importance for the diagnosis of different optic lesions, but is also useful for the prognosis and management of occlusion of the retinal branch vein.
在6只眼中，我们发现了典型体征，这些体征可作为区分缺血性和非缺血性视网膜分支静脉阻塞的标准。视野检查显示，视网膜神经纤维层有缺损的眼睛（在受影响区域）平均缺损超过10 dB，而一只没有神经纤维缺损的眼睛平均缺损为5 dB。其次，荧光素血管造影显示，在所有接受检查的眼睛中，视网膜神经纤维层照片存在局部缺损的区域均有缺血区。在荧光素血管造影能够检测到毛细血管闭塞之前，就观察到了视网膜神经纤维层的损伤。第三，半定量视盘形态测量法表明，将苍白与凹陷之间的差异作为进行性视神经萎缩的唯一体征并不总是有用的。第四，视网膜神经纤维层摄影显示，缺血区的范围与视网膜神经纤维层缺损的扇形角度之间没有相关性。视网膜神经纤维层摄影能够定性检测局部视网膜神经纤维层缺损，从而区分缺血性和非缺血性视网膜分支静脉阻塞。因此，该方法不仅对不同视神经病变的诊断具有重要临床意义，而且对视网膜分支静脉阻塞的预后和治疗也很有用。
