Retina Division, Jules Stein Eye Institute, David Geffen School of Medicine at University of California, Los Angeles, California 90095-7000, USA.
Ophthalmology. 2010 Apr;117(4):780-4. doi: 10.1016/j.ophtha.2009.09.019. Epub 2010 Jan 4.
To study the peripheral angiographic features of branch retinal vein occlusions (BRVO) and hemicentral retinal vein occlusions (HRVO) and explore associations with macular edema and neovascularization.
Retrospective observational case series.
Seventy-eight outpatients.
An imaging database of angiograms performed at a single academic institution was searched for patients with a diagnosis of BRVO or HRVO. Images were graded for the presence of untreated nonperfusion (areas without evidence of laser photocoagulation), late peripheral vascular leakage (LPVL), neovascularization, macular edema, and prior laser treatment. Optical coherence tomography images were reviewed for all patients to confirm the presence of macular thickening and to exclude eyes with vitreomacular traction.
Angiographic evidence of nonperfusion, neovascularization, macular edema, LPVL, and prior laser treatment.
Angiograms from 80 eyes of 78 patients were analyzed with a diagnosis of BRVO (86%) or HRVO (14%). Angiographic macular edema (80%), untreated nonperfusion (82%), neovascularization (21%), and LPVL (58%) were observed. Untreated nonperfusion at any location was significantly associated with macular edema (P = 0.043). Untreated nonperfusion anterior to the globe equator was significantly associated with macular edema (P = 0.007). Untreated nonperfusion was significantly associated with the presence of neovascularization (P = 0.033). Late peripheral vascular leakage was not associated with other angiographic or clinical findings studied.
Ultra wide-field angiography provides visualization of peripheral retinal pathology in BRVO and HRVO patients, which may be useful in their evaluation and treatment. Our findings support the hypothesis that areas of untreated retinal nonperfusion may be the source of production of biochemical mediators that promote neovascularization and macular edema.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
研究分支视网膜静脉阻塞（BRVO）和半中央视网膜静脉阻塞（HRVO）的外周血管造影特征，并探讨其与黄斑水肿和新生血管形成的关系。
回顾性观察性病例系列。
78 名门诊患者。
在一家学术机构进行的血管造影图像数据库中搜索诊断为 BRVO 或 HRVO 的患者。对存在未经治疗的无灌注区（无激光光凝证据的区域）、晚期周边血管渗漏（LPVL）、新生血管形成、黄斑水肿和既往激光治疗的图像进行分级。对所有患者进行光学相干断层扫描图像检查，以确认存在黄斑增厚并排除伴有玻璃体黄斑牵引的眼睛。
无灌注、新生血管形成、黄斑水肿、LPVL 和既往激光治疗的血管造影证据。
对 78 例患者的 80 只眼的血管造影进行了分析，诊断为 BRVO（86%）或 HRVO（14%）。观察到血管造影黄斑水肿（80%）、未经治疗的无灌注（82%）、新生血管形成（21%）和 LPVL（58%）。任何部位未经治疗的无灌注与黄斑水肿显著相关（P=0.043）。球赤道前未经治疗的无灌注与黄斑水肿显著相关（P=0.007）。未经治疗的无灌注与新生血管形成的存在显著相关（P=0.033）。晚期周边血管渗漏与研究中的其他血管造影或临床发现无关。
超广角血管造影可显示 BRVO 和 HRVO 患者的周边视网膜病变，这可能对其评估和治疗有用。我们的研究结果支持以下假说：未经治疗的视网膜无灌注区可能是产生促进新生血管形成和黄斑水肿的生化介质的来源。
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