Hanazaki Hirotsugu, Yokota Harumasa, Aso Hiroshi, Yamagami Satoru, Nagaoka Taiji
Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Tokyo, Japan.
Am J Ophthalmol Case Rep. 2021 Feb 2;21:101022. doi: 10.1016/j.ajoc.2021.101022. eCollection 2021 Mar.
To report the changes over time in ocular blood flow quantified by laser speckle flowgraphy (LSFG) in a treated large retinal arterial macroaneurysm (RAM).
A 72-year old female presented with sudden decreased vision in the left eye. Fundus examination revealed a RAM and vitreous hemorrhage (VH), which worsened over one month. A vitrectomy was performed to remove the VH, with 20% sulfur hexafluoride injected into the vitreous cavity. The VH recurred two weeks later and the RAM was found to have enlarged from one-quarter disc diameter (DD) to three DDs during a second vitrectomy. The RAM subsequently shrunk spontaneously to one DD without recurrent VH during the following 2 weeks. Beginning 4 weeks after the second vitrectomy we performed serial LSFG examinations of the RAM and found that the mean blur rate (MBR) of the RAM and retinal flow volume (RFV) in both the feeding arteriole and draining venule decreased as the RAM continued to involute.
MBR and arteriolar and venular RFV measured by LSFG decreased with RAM involution. Longitudinal followup of blood flow by LSFG may be useful for noninvasive evaluation of the stability of RAMs.
报告经治疗的大型视网膜动脉大动脉瘤（RAM）中，通过激光散斑血流图（LSFG）量化的眼血流随时间的变化。
一名72岁女性左眼视力突然下降。眼底检查发现一个RAM和玻璃体积血（VH），在一个月内病情恶化。进行了玻璃体切除术以清除VH，并向玻璃体腔注入20%的六氟化硫。两周后VH复发，在第二次玻璃体切除术中发现RAM从四分之一视盘直径（DD）增大到了三个DD。随后在接下来的2周内，RAM自发缩小至一个DD，且VH未复发。在第二次玻璃体切除术后4周开始，我们对RAM进行了系列LSFG检查，发现随着RAM持续 involute，RAM的平均模糊率（MBR）以及供血小动脉和引流小静脉中的视网膜血流量（RFV）均下降。
通过LSFG测量的MBR以及小动脉和小静脉的RFV随RAM involution而降低。通过LSFG对血流进行纵向随访可能有助于对RAM的稳定性进行无创评估。
