Department of Ophthalmology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Retina. 2010 Mar;30(3):479-84. doi: 10.1097/IAE.0b013e3181b9b3a0.
The purpose of this study was to assess the risk factors for central retinal vein occlusion and associated morbidity and mortality in a Chinese population.
The participants included patients with central retinal vein occlusion 40 years old and younger. Predisposing factors, mortality, and systemic complications were examined in this group.
Unilateral (n = 19) and bilateral (n = 3) central retinal vein occlusions were identified in a total of 22 patients (25 eyes), with a mean follow-up time of 37 months. Hypercholesterolemia (65%), hypertriglyceridemia (64%), and hyperhomocysteinemia (42%) were all identified as risk factors. Three patients (14%) developed stroke and 1 (5%) developed transient ischemic attacks during follow-up. Renal failure and pulmonary hypertension resulted in the death of two patients. The mean initial and final visual acuities (+ or - standard deviation) were 20/400 (+ or - 20/250) and 20/500 (+ or - 20/320), respectively, and treatments did not result in vision improvement (P = 0.57). The poor visual prognosis was likely due to macular edema in 7 eyes (28%), optic atrophy in 4 eyes (16%), and secondary glaucoma in 3 eyes (12%).
Morbidity and mortality are high in young Chinese patients with central retinal vein occlusion who may have associated serious complications including stroke, blindness, and death. Central retinal vein occlusion may serve as an initial clinical presentation of serious systemic diseases.
本研究旨在评估中国人群中视网膜中央静脉阻塞的危险因素及其相关发病率和死亡率。
纳入研究的对象为年龄在 40 岁及以下的视网膜中央静脉阻塞患者。在该组人群中检查了易患因素、死亡率和全身并发症。
共发现 22 例(25 只眼)患者存在单侧(n=19)和双侧(n=3)视网膜中央静脉阻塞,平均随访时间为 37 个月。高胆固醇血症(65%)、高三酰甘油血症(64%)和高同型半胱氨酸血症(42%)均被确定为危险因素。3 例(14%)患者在随访期间发生脑卒中,1 例(5%)患者发生短暂性脑缺血发作。肾衰竭和肺动脉高压导致 2 例患者死亡。初始和最终平均视力(+或-标准差)分别为 20/400(+或-20/250)和 20/500(+或-20/320),治疗并未改善视力(P=0.57)。7 只眼(28%)出现黄斑水肿、4 只眼(16%)出现视神经萎缩、3 只眼(12%)出现继发性青光眼,导致预后较差。
中国年轻的视网膜中央静脉阻塞患者发病率和死亡率较高,可能存在包括脑卒中、失明和死亡在内的严重并发症。视网膜中央静脉阻塞可能是严重全身性疾病的初始临床表现。