Iijima H, Satoh S, Tsukahara S
Department of Ophthalmology, Yamanashi Medical University, Tamaho, Japan.
Retina. 1998;18(5):430-4. doi: 10.1097/00006982-199805000-00008.
To document the clinical course of Nd:YAG laser photodisruption for eyes with preretinal hemorrhage following rupture of a retinal macroaneurysm.
We reviewed six eyes of five patients with preretinal hemorrhage due to retinal macroaneurysm that received Nd:YAG laser photodisruption. Nd:YAG laser created a focal opening in the anterior surface of the preretinal hemorrhage, permitting the blood to enter the vitreous cavity where it would be absorbed more rapidly.
Three eyes showed both subhyaloid hemorrhage, which was resorbed without treatment within 2 months, and hemorrhagic detachment of the internal limiting membrane (ILM), which required Nd:YAG laser photodisruption. All eyes showed disappearance of the preretinal hemorrhage and improvement of vision within 1 week of Nd:YAG laser photodisruption. Visual recovery was less prominent in eyes associated with subretinal macular hemorrhage.
Preretinal hemorrhage due to a ruptured retinal macroaneurysm could be dispersed into the vitreous cavity with Nd:YAG laser photodisruption. It should be considered in the decision of Nd:YAG laser photodisruption that the visual increment may be limited in eyes that also have subretinal hemorrhage in the macula and that the hemorrhage beneath the ILM tends to remain longer than the subhyaloid hemorrhage.
记录视网膜大动脉瘤破裂后视网膜前出血患者接受钕钇铝石榴石（Nd:YAG）激光光凝治疗的临床过程。
我们回顾了5例因视网膜大动脉瘤导致视网膜前出血并接受Nd:YAG激光光凝治疗的患者的6只眼睛。Nd:YAG激光在视网膜前出血的前表面造成一个聚焦开口，使血液进入玻璃体腔，在那里血液吸收更快。
3只眼睛既有玻璃膜下出血，在2个月内未经治疗自行吸收，又有内界膜（ILM）出血性脱离，需要Nd:YAG激光光凝治疗。所有眼睛在接受Nd:YAG激光光凝治疗后1周内视网膜前出血均消失，视力改善。与黄斑下视网膜出血相关的眼睛视力恢复不太明显。
视网膜大动脉瘤破裂引起的视网膜前出血可通过Nd:YAG激光光凝分散到玻璃体腔中。在决定是否进行Nd:YAG激光光凝治疗时应考虑到，黄斑区同时存在视网膜下出血的眼睛视力提高可能有限，且ILM下的出血往往比玻璃膜下出血持续时间更长。
