Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, 606-8507, Japan.
Sci Rep. 2022 Jan 11;12(1):503. doi: 10.1038/s41598-021-04500-4.
The aim of this retrospective, observational study was to examine the intraretinal locations of ruptured retinal arterial macroaneurysms (RMAs) and investigate the associations with the visual prognosis. Fifty patients (50 eyes) with untreated RMA rupture who visited the Department of Ophthalmology at Kyoto University Hospital (April 2014-July 2019) were included. The intraretinal position of the ruptured RMAs relative to the affected retinal artery was examined using optical coherence tomography (OCT) and color fundus photography (CFP). The relative RMA positions were anterior to (anterior type, 44%), at the same level as (lateral type, 20%), or posterior to (posterior type, 34%) the affected artery. At the initial visit, the posterior type showed greater subretinal hemorrhage thickness than did the lateral and anterior types (P = 0.016 and 0.006, respectively), and poorer visual acuity (VA) than did the anterior type (P = 0.005). At the final visit, the length of the foveal ellipsoid zone band defect was longer (P = 0.005) and VA was poorer (P < 0.001) for the posterior type than for the anterior type. The intraretinal positions of ruptured RMAs vary, affect the thickness of foveal subretinal hemorrhage and predict future damage to the foveal photoreceptors. The visual prognosis may be poor for posteriorly ruptured RMAs.
本回顾性观察研究旨在探讨破裂的视网膜动脉大动脉瘤（RMAs）的视网膜内位置，并研究其与视觉预后的关系。纳入了 50 名（50 只眼）未治疗的 RMA 破裂患者，这些患者均就诊于京都大学医院眼科（2014 年 4 月至 2019 年 7 月）。使用光学相干断层扫描（OCT）和眼底彩色照相术（CFP）检查破裂的 RMAs 相对于受影响的视网膜动脉的视网膜内位置。相对 RMA 位置在受影响动脉之前（前型，44%）、与受影响动脉平齐（侧型，20%）或在受影响动脉之后（后型，34%）。在初次就诊时，后型的视网膜下出血厚度大于侧型和前型（P = 0.016 和 0.006），视力（VA）也比前型差（P = 0.005）。在最终就诊时，后型的黄斑椭圆体带缺损的长度较长（P = 0.005），VA 也较前型差（P < 0.001）。破裂的 RMAs 的视网膜内位置不同，影响黄斑区视网膜下出血的厚度，并预测黄斑区光感受器的未来损伤。后型 RMAs 的预后可能较差。
