Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Ophthalmology, Kagawa University Faculty of Medicine, Miki, Japan.
Sci Rep. 2016 Jun 23;6:28554. doi: 10.1038/srep28554.
This prospective study included 63 eyes with acute branch retinal vein occlusion (BRVO) to evaluate the retinal hemorrhagic patterns at the posterior poles and explore their clinical relevance in macular perfusion differentiation. Retinal hemorrhagic patterns and macular perfusion status were evaluated via fundus photography and fluorescein angiography, respectively. Macular perfusion was judged as nonischemic in 30, ischemic in 28, and undeterminable in 5 among the 63 eyes. Predominant hemorrhagic patterns were flame-shaped in 39 (67.2%) and non-flame-shaped in 19 (32.8%) eyes. All 39 eyes with a flame-shaped hemorrhage showed a nonischemic macula. Of the 19 eyes classified as having a non-flame-shaped hemorrhage, 13 (68.4%) had an ischemic macula and 6 (31.6%) had a nonischemic macula (P < 0.001). Parallelism in eyes with a flame-shaped hemorrhage was higher than in those with a non-flame-shaped hemorrhage (P < 0.001), and in those with a nonischemic macula versus those with an ischemic macula (P < 0.001). The area under the curve for parallelism was 0.975 (P < 0.001), suggesting an accurate diagnostic parameter for macular perfusion differentiation. In conclusion, we objectively evaluated retinal hemorrhagic patterns at the posterior pole in BRVO using the parallelism method, which was useful in differentiating macular perfusion status.
本前瞻性研究纳入了 63 只急性分支视网膜静脉阻塞（BRVO）患眼，旨在评估后极部视网膜出血模式，并探讨其在黄斑灌注分化中的临床相关性。通过眼底照相和荧光素血管造影分别评估视网膜出血模式和黄斑灌注状态。63 只眼中，30 只判断为非缺血性、28 只为缺血性、5 只为不可判定。67.2%（39 只眼）的患眼主要表现为火焰状出血，32.8%（19 只眼）为非火焰状出血。所有 39 只表现为火焰状出血的患眼均为非缺血性黄斑。19 只表现为非火焰状出血的患眼中，13 只（68.4%）为缺血性黄斑，6 只（31.6%）为非缺血性黄斑（P<0.001）。火焰状出血的患眼平行度高于非火焰状出血（P<0.001），且非缺血性黄斑的患眼高于缺血性黄斑（P<0.001）。平行度的曲线下面积为 0.975（P<0.001），提示其是一种用于黄斑灌注分化的准确诊断参数。总之，我们采用平行度方法客观评估了 BRVO 后极部的视网膜出血模式，有助于区分黄斑灌注状态。
