Saito K, Iijima H
Department of Ophthalmology, Yamanashi Medical University, Japan.
Nippon Ganka Gakkai Zasshi. 1997 Feb;101(2):148-51.
We studied retrospectively the visual outcome of 20 eyes of 19 patients with symptomatic retinal arterial macroaneurysm. The macular pathology responsible for the acute visual loss was categorized as macular edema (5 eyes), preretinal hemorrhages alone (3 eyes), subretinal hemorrhages with or without preretinal hemorrhages (10 eyes) and vitreous hemorrhage (2 eyes). Thirteen eyes were treated with argon or dye laser photocoagulation. Five eyes with preretinal hemorrhage underwent YAG laser photodisruption of the posterior hyaloid membrane to release the preretinal hemorrhage into the vitreous space. Five eyes with macular edema, 3 eyes with preretinal hemorrhage without subretinal hemorrhage and 2 eyes with vitreous hemorrhage showed final vision of 0.5 or better, but of the other 10 eyes with subretinal hemorrhage with or without preretinal hemorrhage, 9 showed final visual acuity of 0.2 or worse. Visual prognosis of submacular hemorrhage due to ruptured retinal macroaneurysm is poor, but that of macular edema, preretinal hemorrhage or vitreous hemorrhage is relatively good.
我们回顾性研究了19例有症状的视网膜动脉大动脉瘤患者的20只眼的视力预后。导致急性视力丧失的黄斑病变分为黄斑水肿(5只眼)、单纯视网膜前出血(3只眼)、伴有或不伴有视网膜前出血的视网膜下出血(10只眼)和玻璃体积血(2只眼)。13只眼接受了氩激光或染料激光光凝治疗。5只视网膜前出血的眼睛接受了YAG激光对玻璃体后界膜的光破碎,以使视网膜前出血进入玻璃体腔。5只黄斑水肿的眼睛、3只无视网膜下出血的视网膜前出血眼睛和2只玻璃体积血的眼睛最终视力达到0.5或更好,但在其他10只伴有或不伴有视网膜前出血的视网膜下出血眼睛中,9只最终视力为0.2或更差。视网膜大动脉瘤破裂导致的黄斑下出血视力预后较差,但黄斑水肿、视网膜前出血或玻璃体积血的视力预后相对较好。