Amoaku W M, Archer D B
Eye and Ear Clinic, Royal Victoria Hospital, Belfast, Northern Ireland.
Eye (Lond). 1990;4 ( Pt 5):657-67. doi: 10.1038/eye.1990.93.
Fifteen patients who developed retinopathy following radiotherapy for cephalic tumours were studied by fluorescein angiography. Nine patients with unilateral or bilateral retinopathy had serial angiograms at six monthly or yearly intervals. Angiography revealed a wide range of retinal microvascular changes which were graded 1-4 according to the extent and degree of capillary malformation, incompetence and closure. All patients showed slow progression of retinopathy with remodelling of the affected microvasculature and increased capillary fallout and leakage to dye. The earliest retinopathic changes were capillary dilatation and closure and microaneurysm formation. Telangiectatic-like vessels were a feature of the established retinopathy and probably represented collateral channels which bordered sites of capillary occlusion. Two patients with progressive macular oedema and declining vision responded favourably to focal laser photocoagulation which returned a measure of competence to some residual dilated capillaries.
对15例因头部肿瘤放疗后发生视网膜病变的患者进行了荧光素血管造影研究。9例单侧或双侧视网膜病变患者每隔6个月或1年进行系列血管造影。血管造影显示视网膜微血管有广泛变化，根据毛细血管畸形、功能不全和闭塞的程度和范围分为1 - 4级。所有患者视网膜病变均呈缓慢进展，受累微血管发生重塑，毛细血管脱落和染料渗漏增加。最早的视网膜病变改变是毛细血管扩张、闭塞和微动脉瘤形成。类毛细血管扩张样血管是已形成的视网膜病变的一个特征，可能代表与毛细血管闭塞部位相邻的侧支通道。2例患有进行性黄斑水肿和视力下降的患者对局部激光光凝治疗反应良好，使一些残留的扩张毛细血管恢复了一定的功能。
