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虹膜红变和新生血管性青光眼的微血管注射研究

Microvascular injection studies in rubeosis iridis and neovascular glaucoma.

作者信息

Jocson V L

出版信息

Am J Ophthalmol. 1977 Apr;83(4):508-17. doi: 10.1016/0002-9394(77)90558-x.

Abstract

Microvascular silicone injection, tissue clearing, and histologic examination were used to demonstrate the origin, distribution, and interconnections of newly formed iris and chamber angle blood vessels in four eyes with rubeosis iridis and neovascular glaucoma associated with diabetic retinopathy and central retinal vessel occlusion. The newly formed iris vessels that formed either a tight, evenly distributed (diabetic) or loose, irregularly distributed (central vessel occlusion) network in the iris originated from the normal iris arteries that were branches of either the major arterial circle or of the perforating branches of the anterior ciliary arteries, and drained into the normal iris and ciliary body veins and occasionally into the paralimbal episcleral veins. These newly formed iris vessels appeared to shunt intravascular fluid from arteries to veins. The newly formed anterior chamber angle vessels that formed tufts and arcades at the trabecular meshwork also originated from the roots of the iris arteries and the ciliary body arteries and connected with the peripheral neovascular iris network. In addition, the circumferentially running angle vessels that coursed within the trabecular meshwork branched into and coursed within a fibrosed Schlemm's canal and into two of its intrascleral collector channels. No open communication between these newly formed vessels and the Schlemm's canal-aqueous outflow system was seen.

摘要

对4例患有虹膜新生血管和新生血管性青光眼(与糖尿病性视网膜病变及视网膜中央血管阻塞相关)的眼睛,采用微血管硅注射、组织透明化及组织学检查,以显示新形成的虹膜和房角血管的起源、分布及相互连接情况。新形成的虹膜血管在虹膜内形成紧密、分布均匀(糖尿病性)或疏松、分布不规则(中央血管阻塞)的网络,其起源于正常虹膜动脉,这些动脉是大动脉环或睫状前动脉穿支的分支,并汇入正常的虹膜和睫状体静脉,偶尔也汇入角巩膜缘浅层巩膜静脉。这些新形成的虹膜血管似乎将血管内液体从动脉分流至静脉。新形成的房角血管在小梁网处形成丛状和弓状结构,同样起源于虹膜动脉根部和睫状体动脉,并与周边新生血管性虹膜网络相连。此外,在小梁网内沿圆周走行的房角血管分支进入纤维性施莱姆管并在其中走行,还进入其两条巩膜内集合管。未观察到这些新形成的血管与施莱姆管 - 房水流出系统之间存在开放的交通。

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