Cohen S M, Davis J L, Gass D M
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami (Fla) School of Medicine, USA.
Arch Ophthalmol. 1995 Oct;113(10):1271-6. doi: 10.1001/archopht.1995.01100100059029.
To determine the natural history and visual prognosis of patients with branch retinal arterial occlusions secondary to multifocal retinitis.
Cases were reviewed for seven patients who exhibited multifocal retinitis and branch retinal arterial occlusion. The average age of the patients was 27 years (age range, 14 to 19 years).
Six patients had systemic illnesses associated with their ocular findings. Four patients were scratched by a cat or exposed to a cat with fleas within 1 month of symptoms. Three of these patients were tested and had positive cat-scratch disease titers. At presentation, five patients complained of a scotoma, and two noted blurred vision. On examination, visual acuity was 20/25 or better in all but one eye. Five patients had vitritis, which was bilateral in three. Four patients exhibited optic nerve edema, which was bilateral in two. White intraretinal infiltrates were present in all patients, and were bilateral in five. The six patients who were examined within 1 week of symptoms had a white retinal infiltrate at the site of vascular occlusion. The retinal findings resolved in 2 to 6 weeks and did not recur. The final visual acuity was 20/20 OU in all patients.
Branch retinal arterial occlusions represent a complication of multifocal retinitis and idiopathic optic nerve edema. The arterial occlusions are probably caused by a focus of retinitis. This self-limited disorder has an excellent visual prognosis and may be related to cat-scratch disease.
确定多灶性视网膜炎继发视网膜分支动脉阻塞患者的自然病程和视力预后。
回顾了7例表现为多灶性视网膜炎和视网膜分支动脉阻塞的患者病例。患者的平均年龄为27岁（年龄范围为14至19岁）。
6例患者的全身疾病与眼部表现相关。4例患者在出现症状的1个月内被猫抓伤或接触过有跳蚤的猫。其中3例患者接受检测，猫抓病滴度呈阳性。就诊时，5例患者主诉有暗点，2例患者有视力模糊。检查发现，除1只眼外，所有患眼的视力均为20/25或更好。5例患者有玻璃体炎，其中3例为双侧。4例患者出现视神经水肿，其中2例为双侧。所有患者均有视网膜内白色浸润，5例为双侧。在出现症状1周内接受检查的6例患者，在血管阻塞部位有视网膜白色浸润。视网膜病变在2至6周内消退，未复发。所有患者最终视力均为双眼20/20。
视网膜分支动脉阻塞是多灶性视网膜炎和特发性视神经水肿的一种并发症。动脉阻塞可能由视网膜炎病灶引起。这种自限性疾病视力预后良好，可能与猫抓病有关。
