Theoulakis P E, Livieratou A, Petropoulos I K, Lepidas J, Brinkmann C K, Katsimpris J M
Department of Ophthalmology, Royal Free Hospital NHS Trust, London, UK.
Klin Monbl Augenheilkd. 2010 Apr;227(4):302-5. doi: 10.1055/s-0029-1245291. Epub 2010 Apr 20.
We describe the clinical findings and course of cilioretinal artery occlusion (CAO) combined with central retinal vein occlusion (CRVO) in two patients and present a review of the relevant literature.
Case 1: An otherwise healthy 24-year-old woman presented to the emergency unit with a painless visual decrease in her right eye. Fundus examination revealed retinal edema due to CAO in association with signs of venous stasis. Fluorescein angiography (FA) showed a patent cilioretinal artery. Case 2: A heavy smoker, hypertensive, 59-year-old man was referred for sudden visual loss in his left eye. Fundus examination and FA revealed CAO and CRVO.
No treatment was applied for the first patient. Two weeks after diagnosis, retinal edema had subsided and only the signs of venous stasis were evident. The central scotoma remained unchanged. In the second patient, within the next three months, the development of retinal ischemia led to retinal neovascularization. Panretinal photocoagulation was applied. Visual acuity remained very low (light perception).
The combination of CAO and CRVO comprises a discrete clinical entity. In both our cases, FA did not show full obstruction of the cilioretinal artery. Even though many hypotheses have been postulated about this entity, it seems that it ensues from the increased intraluminal pressure in the retinal capillaries (due to the CRVO), which exceeds the pressure in the cilioretinal artery. Thus, it is probably a functional obstruction of the cilioretinal artery, although its pathogenesis remains controversial.
我们描述了两名睫状视网膜动脉阻塞（CAO）合并视网膜中央静脉阻塞（CRVO）患者的临床发现及病程，并对相关文献进行了综述。
病例1：一名24岁健康女性因右眼无痛性视力下降就诊于急诊科。眼底检查发现因CAO导致的视网膜水肿以及静脉淤滞的体征。荧光素血管造影（FA）显示睫状视网膜动脉通畅。病例2：一名59岁男性，重度吸烟者且患有高血压，因左眼突然视力丧失前来就诊。眼底检查和FA显示为CAO和CRVO。
第一名患者未接受治疗。诊断后两周，视网膜水肿消退，仅静脉淤滞体征明显。中心暗点未变。第二名患者在接下来的三个月内，视网膜缺血发展导致视网膜新生血管形成。进行了全视网膜光凝治疗。视力仍极低（仅存光感）。
CAO和CRVO合并存在构成一种独特的临床病症。在我们的两个病例中，FA均未显示睫状视网膜动脉完全阻塞。尽管对此病症提出了许多假说，但似乎是由于视网膜毛细血管内压力升高（由于CRVO）超过了睫状视网膜动脉内压力所致。因此，这可能是睫状视网膜动脉的功能性阻塞，尽管其发病机制仍存在争议。
