Rudkin Adam K, Lee Andrew W, Chen Celia S
Department of Ophthalmology, NH and MRC Centre of Clinical Eye Research, Flinders Medical Centre and Flinders University, Adelaide, SA 5042, Australia.
Eur J Ophthalmol. 2010 Nov-Dec;20(6):1042-6. doi: 10.1177/112067211002000603.
Debate exists in the literature on the prevalence and etiology of neovascularization following central retinal artery occlusion (CRAO). The reported prevalence varies from 2.5% to 31.6%. We conducted a retrospective study to determine the prevalence of ocular neovascularization following acute CRAO in our institution.
A retrospective audit of consecutive patients with nonarteritic/thromboembolic CRAO presenting between 1997 and 2009 in a single tertiary teaching hospital.
Thirty-three patients were identified as having nonarteritic CRAO, and of this cohort 6 patients (18.2%) developed ocular neovascularization. Neovascular glaucoma was present in 5 cases (15.2%); 2 of these presented through an emergency department with painful eyes, both at 16 weeks post CRAO. The other cases of neovascularization were detected on scheduled follow-ups. Mean time from retinal occlusive event to observed neovascularization was 8.5 weeks (range 2-16 weeks). One case of neovascularization was associated with hemodynamically significant ipsilateral carotid stenosis; no patient had proliferative diabetic retinopathy or other causes of neovascularization.
The prevalence of neovascularization following acute CRAO in our population was 18.2% at an average of 8.5 weeks post CRAO. There was a temporal relationship between the 2 events and no other causes of neovascularization demonstrable in our cohort of patients. There is no consensus on the follow-up regimen post CRAO to detect ocular neovascularization complications. Our study suggests that neovascularization can occur early and regular follow-up especially in the first 4 months is important post CRAO.
关于视网膜中央动脉阻塞（CRAO）后新生血管形成的患病率和病因，文献中存在争议。报道的患病率从2.5%到31.6%不等。我们进行了一项回顾性研究，以确定在我们机构中急性CRAO后眼部新生血管形成的患病率。
对1997年至2009年期间在一家单一的三级教学医院就诊的连续性非动脉性/血栓栓塞性CRAO患者进行回顾性审计。
33例患者被确定为患有非动脉性CRAO，其中6例（18.2%）发生了眼部新生血管形成。5例（15.2%）出现新生血管性青光眼；其中2例通过急诊科就诊，眼睛疼痛，均在CRAO后16周出现。其他新生血管形成病例在定期随访中被发现。从视网膜阻塞事件到观察到新生血管形成的平均时间为8.5周（范围为2 - 16周）。1例新生血管形成与同侧具有血流动力学意义的颈动脉狭窄相关；没有患者患有增殖性糖尿病视网膜病变或其他新生血管形成的原因。
在我们的人群中，急性CRAO后新生血管形成的患病率在CRAO后平均8.5周时为18.2%。这两个事件之间存在时间关系，并且在我们的患者队列中没有其他可证实的新生血管形成原因。对于CRAO后检测眼部新生血管形成并发症的随访方案尚无共识。我们的研究表明，新生血管形成可能早期发生，尤其是在CRAO后的前4个月进行定期随访很重要。
