重度高血压肾病患者的眼底荧光血管造影

Fundus fluorescein angiography of patients with severe hypertensive nephropathy.

作者信息

Lafaut B A, De Vriese A S, Stulting A A

机构信息

Department of Ophthalmology, National Hospital, University of the Free State, Bloemfontein, Republic of South Africa.

出版信息

Graefes Arch Clin Exp Ophthalmol. 1997 Dec;235(12):749-54. doi: 10.1007/BF02332858.

DOI:10.1007/BF02332858

PMID:9439966

Abstract

PURPOSE

To analyze the fluorescein angiograms of patients with hypertensive renal failure.

METHODS

Fluorescein angiograms were obtained of 34 patients with hypertensive renal failure. The glomerular filtration was less than 20 ml/min in each patient.

RESULTS

Capillary nonperfusion and a coarse retinal capillary bed are the hallmark of the hypertensive retinopathy. Tortuous retinal arterioles or tortuous retinal arteriovenous anastomoses are observed. It is suggested that capillary collaterals shunt arteriolar obstructions or short-cut nonperfused capillary beds; these remodel into tortuous arterioles or arteriovenous anastomoses with regular caliber. Elschnig spots and delayed choroidal filling are signs of hypertensive choroidopathy. Depigmentation spots of the retinal pigment epithelium without a central pigment clump are considered atypical Elschnig spots.

CONCLUSIONS

Retinal pigment epithelial changes are permanent scars of hypertensive choroidopathy, while coarse retinal capillary bed and tortuous retinal arterioles or arteriovenous anastomoses are the result of hypertensive retinopathy in these patients with hypertensive renal failure.

摘要

目的

分析高血压性肾衰竭患者的荧光素血管造影。

方法

对34例高血压性肾衰竭患者进行荧光素血管造影。每位患者的肾小球滤过率均低于20毫升/分钟。

结果

毛细血管无灌注和视网膜毛细血管床粗糙是高血压性视网膜病变的特征。可见视网膜小动脉迂曲或视网膜动静脉吻合支迂曲。提示毛细血管侧支分流小动脉阻塞或捷径非灌注毛细血管床；这些会重塑为管径规则的迂曲小动脉或动静脉吻合支。Elschnig斑和脉络膜充盈延迟是高血压性脉络膜病变的体征。视网膜色素上皮无中央色素团块的色素脱失斑被认为是非典型Elschnig斑。