Vitreous, Retina, Macula Consultants of New York, New York.
Department of Ophthalmology, Hospital Universitari de Bellvitge, Barcelona, Spain.
Retina. 2019 Oct;39(10):1889-1895. doi: 10.1097/IAE.0000000000002406.
To investigate eyes with solitary large aneurysms arising from retinal capillaries.
Consecutive patients with aneurysms greater than 200 µm in diameter were evaluated with a comprehensive ophthalmologic examination including optical coherence tomography, optical coherence tomography angiography, and fluorescein angiography. The aneurysms were solitary in the sense, and there was only one aneurysm larger than the threshold diameter and a few or no other aneurysms.
There were 5 patients, 3 male patients, who had aneurysms that reached a maximal mean size of 273.4 µm. One patient had stable diabetic retinopathy and had a documented growth of a capillary aneurysm to 331 µm over an 8-year 7-month period until the aneurysm was associated with widespread edema. The remaining 4 patients did not have diabetes or any discernable retinal vascular disease. Anti-vascular endothelial growth factor treatment was associated with a partial response in one patient and no apparent response in the others. Laser photocoagulation of the aneurysms resulted in resolution of the edema and involution of the lesions.
Large aneurysms arising from retinal capillaries occur and have a candidate name of retinal capillary macroaneurysms. Histologic evaluation of retinal capillary aneurysms shows the presence of matrix metalloproteinase-9, which may function to decrease the wall strength in the face of increasing wall tension from aneurysmal expansion, as predicted by LaPlace's law. Thus, retinal capillary macroaneurysms may have multiple forces driving their formation.
研究源于视网膜毛细血管的孤立性大动脉瘤眼。
对直径大于 200µm 的动脉瘤患者进行全面眼科检查，包括光学相干断层扫描、光学相干断层扫描血管造影和荧光素血管造影。这些动脉瘤在意义上是孤立的，只有一个大于阈值直径的动脉瘤，并且只有少数或没有其他动脉瘤。
共有 5 名男性患者，动脉瘤最大平均直径达到 273.4µm。1 名患者患有稳定的糖尿病性视网膜病变，其毛细血管动脉瘤在 8 年 7 个月的时间内增长至 331µm，直至动脉瘤与广泛水肿相关。其余 4 名患者没有糖尿病或任何明显的视网膜血管疾病。抗血管内皮生长因子治疗在 1 名患者中引起部分反应，而在其他患者中没有明显反应。对动脉瘤进行激光光凝导致水肿消退和病变退缩。
源于视网膜毛细血管的大动脉瘤发生，并有一个候选名称为视网膜毛细血管巨动脉瘤。对视网膜毛细血管动脉瘤的组织学评估显示存在基质金属蛋白酶-9，根据拉普拉斯定律，它可能有助于在动脉瘤扩张导致的壁张力增加的情况下降低壁强度。因此，视网膜毛细血管巨动脉瘤的形成可能有多种力驱动。
