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中心凹旁毛细血管与分支视网膜静脉阻塞伴黄斑水肿的病理形态学关系。

Relationship between perifoveal capillaries and pathomorphology in macular oedema associated with branch retinal vein occlusion.

机构信息

Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo, Kyoto, Japan.

出版信息

Eye (Lond). 2012 Jun;26(6):771-80. doi: 10.1038/eye.2012.85. Epub 2012 Jun 1.

Abstract

PURPOSE

To study the relationship between macular ischaemia on fluorescein angiography (FA) and pathomorphology at the foveal centre delineated by spectral-domain optical coherence tomography (OCT) in macular oedema (MO) associated with branch retinal vein occlusion (BRVO).

METHODS

One hundred and five consecutive eyes of 105 patients with MO (centre point thickness (CPT) ≥ 300 μm) associated with BRVO in which FA using Heidelberg Retinal Angiography 2 and Spectralis OCT were performed on the same day were retrospectively reviewed. We evaluated the foveal pathomorphology using OCT images and the association with macular ischaemia.

RESULTS

Within 1 year from symptom onset, 94 eyes were classified with perfused macula (34 eyes) or non-perfused macula (60 eyes). Eyes with perfused macula had better visual acuity and less CPT than those with non-perfused macula (P=0.024 and P<0.001, respectively). Fourteen eyes with perfused macula had serous retinal detachment (SRD) alone at the presumed foveal centre (SRD type); seven, a sponge-like swelling at that area (retinal swelling type); 11, foveal cystoid spaces alone (cystoid MO (CMO) type), and 2, with both SRD and foveal cystoid spaces (SRD+CMO type). However, 58 eyes with non-perfused macula had foveal cystoid spaces (42 of CMO type and 16 of SRD+CMO type), with a significant association between them (P<0.001). Among 11 eyes with symptoms exceeding 1 year, 6 eyes had perfused macula, and none had the SRD type.

CONCLUSION

Most eyes without foveal cystoid spaces have perfused macula in MO associated with BRVO.

摘要

目的

研究伴有视网膜分支静脉阻塞(BRVO)的黄斑水肿(MO)中,荧光素眼底血管造影(FA)显示的黄斑缺血与频域光相干断层扫描(OCT)界定的黄斑中心凹形态之间的关系。

方法

回顾性分析 105 例(105 只眼)BRVO 伴 MO 患者(中心凹厚度(CPT)≥300μm)的临床资料,这些患者均于同天接受了海德堡视网膜血管造影 2 系统和 Spectralis OCT 检查。我们利用 OCT 图像评估黄斑中心凹形态,并分析其与黄斑缺血的关系。

结果

在发病 1 年内,94 只眼分为灌注黄斑(34 只眼)和非灌注黄斑(60 只眼)。与非灌注黄斑相比,灌注黄斑的视力较好,CPT 较薄(P=0.024 和 P<0.001)。14 只灌注黄斑的眼在推测的黄斑中心凹仅有浆液性视网膜脱离(SRD)(SRD 型);7 只眼为该区域海绵样隆起(视网膜隆起型);11 只眼仅有黄斑中心凹囊样间隙(CMO 型),2 只眼既有 SRD 又有黄斑中心凹囊样间隙(SRD+CMO 型)。然而,58 只非灌注黄斑的眼均有黄斑中心凹囊样间隙(42 只为 CMO 型,16 只为 SRD+CMO 型),两者有显著相关性(P<0.001)。在症状超过 1 年的 11 只眼中,6 只眼有灌注黄斑,且无一只为 SRD 型。

结论

在 BRVO 伴 MO 中,大多数无黄斑中心凹囊样间隙的眼均有灌注黄斑。

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