视网膜大动脉瘤24例临床特点及治疗方案分析

发布时间：2018-06-25 15:38

本文选题：视网膜大动脉瘤 + 视网膜光凝　；参考：《山东医药》2017年26期

【摘要】：目的总结视网膜大动脉瘤的临床特征,探讨其最佳临床治疗方案。方法回顾性分析24例视网膜大动脉瘤患者的临床资料,包括视力、眼底照相、光学相干断层扫描(OCT)、眼底荧光血管造影(FFA)及治疗方案。其中10例就诊时眼底可见视网膜动脉瘤样扩张伴出血及黄白色渗出,单纯行视网膜光凝治疗;5例就诊时眼底可见视网膜大动脉瘤破裂出血伴有黄白色渗出及黄斑区出血、渗出水肿,黄斑区光学相干断层扫描显示黄斑区水肿、出血及渗出,眼底荧光血管造影确诊视网膜大动脉瘤并黄斑区水肿、出血及渗出,先后行玻璃体腔注射抗VEGF及视网膜光凝治疗;9例因玻璃体腔积血行玻璃体切割清除积血见视网膜出血伴有黄白色渗出,行玻璃体腔抗VEGF注射治疗。治疗后检测患者最佳矫正视力、黄斑中心凹厚度及瘤体变化。结果所有患者眼底检查可见瘤体萎缩、渗出吸收,黄斑区无明显渗出,黄斑中心凹厚度明显减低,最佳矫正视力均不同程度提高。结论视网膜大动脉瘤的临床表现各异,眼底检查和眼底血管造影可明确诊断,应根据视网膜大动脉瘤的病变程度选择最佳安全有效的治疗方案。
[Abstract]:Objective to summarize the clinical features of large retinal artery aneurysms and to explore the best clinical treatment. Methods the clinical data of 24 patients with large retinal artery aneurysms were retrospectively analyzed, including visual acuity, fundus photography, optical coherence tomography (Oct), fundus fluorescein angiography (FFA) and treatment. In 10 cases, retinal aneurysm dilatation accompanied with hemorrhage and yellowish white exudation were found in the fundus of the eye, and 5 cases were treated with retinal photocoagulation alone. The rupture of the retinal aneurysm with yellowish white exudation and macular hemorrhage was seen in the fundus of 5 cases. Exudate edema, macular area optical coherence tomography showed macular edema, hemorrhage and exudation, fundus fluorescein angiography was used to diagnose retinal large artery aneurysm with macular edema, hemorrhage and exudation. Nine cases of vitreous hemorrhage were treated with vitreous hemorrhage with yellowish white exudation due to vitreous hemorrhage and retinal photocoagulation. The best corrected visual acuity, macular foveal thickness and tumor changes were measured after treatment. Results all the patients showed atrophy, exudation and absorption, no obvious exudation in the macular area, a significant decrease in the thickness of the fovea of the macula, and the improvement of the best corrected visual acuity in varying degrees. Conclusion the clinical manifestations of large retinal artery aneurysms are different. Fundus examination and fundus angiography can make a definite diagnosis. The best safe and effective treatment should be selected according to the degree of pathological changes of retinal great artery aneurysms.
【作者单位】：南昌大学第二附属医院;
【分类号】：R774.1

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