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医源性眼部血管阻塞的荧光血管造影分析

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【摘要】 目的 探讨医源性眼部血管阻塞的荧光血管造影(fundus fluorescein angiography,FFA)图像特征性表现。方法 对9例患者(9眼)进行荧光血管造影。结果 9例有明确医源性病史诱发的患者中4例为中央动脉阻塞,FFA表现为早期中央动脉静脉充盈迟缓,晚期视盘高荧光,黄斑周围毛细血管前微动脉充盈缺损;4例为中央动脉阻塞合并中央静脉阻塞,FFA表现为中央动静脉充盈迟缓,后极大量片状低荧光遮挡,黄斑拱环破坏,周围毛细血管前微动脉充盈缺损,后极及周边广泛无灌注区;1例为眼动脉阻塞,FFA表现为脉络膜背景荧光及中央动脉充盈迟缓,血管出视盘后荧光素充盈中断,至晚期不充盈,视网膜周边广泛无灌注区。结论 医源性眼部血管阻塞可引起中央动脉阻塞,中央动脉合并静脉阻塞及眼动脉阻塞,严重程度较重,阻塞范围较广,荧光血管造影表现有所不同,但发病原因、发病机制相似,在临床上应注意鉴别。
 
【关键词】 医源性眼部血管阻塞,荧光血管造影
  
FFA analysis of exogenous ocular vascular occlusion
  
【Abstract】 Objective To explore the characteristic manifestation of FFA of exogenous vascular occlusion.Methods 9 eyes of 9 patients were photographed.Results Of 9 patients with exogenous medical history definitely,4 patients were diagnosed central retinal artery occlusion.FFA showed that central retinal artery and vein perfused slowly during early stage with filling defect of parafoveal arteriole before capillary,the optic disk showed hyperfluorescence during late stage.4 patients were diagnosed the central retinal artery occlusion with central retinal vein occlusion.FFA showed that central retinal vein perfused slowly,posterior pole has many pieces of hypofluorescence block,the foveal vascular arch was destroyed with filling defect of peripheral arteriole before capillary and there were extensive nonperfusion areas at the posterior pole and peripheral areas;1 patient was diagnosed ocular artery occlusion.FFA showed that choroidal background fluorescence and central artery were perfused slowly,the vascular fluorescence perfusion was interrupted before optic disk and the perfusion interruption continued until late stage with extensive peripheral nonperfusion areas.Conclusion Exogenous ocular vascular block can cause central retinal artery occlusion,central retinal artery occlusion with central retinal vein occlusion and ocular artery occlusion.These diseases are very severe and the block area is very extensive.Though manifestation of FFA is different,the etiology and mechanism are similar.It is very important to differentiate it from others in clinical.
  
【Key words】 exogenous ocular vascular occlusion;fundus fluorescein angiography
目录:
  1 资料与方法

  2 结果

  3 讨论


参考文献:
 1 黄叔仁,张晓峰.眼底病诊断与治疗.北京:人民卫生出版社,2003,77.
  2 张承芬.眼底病学.北京:人民卫生出版社,1997,180,185.
  3 田农,王理理,王义.医源性视网膜中央动脉阻塞2例.中国实用眼科杂志,2004,22:936.
  4 曾涛.球后阻滞麻醉致视网膜中央动脉阻塞1例.中国中医眼科杂志,1998,11:109.
  5 侯承花,于时英.巩膜扣带术后视网膜中央动脉阻塞.中国实用眼科杂志,1999,17:84.

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