Exudative Retinal Detachment Subsequent to Central Retinal Vein Occlusion

中心性視網膜靜脈阻塞後並滲出性視網膜剝離

魏利眞(Li-Chen Wei) ； 陳珊霓(San-Ni Chen) ； 何昭德(Jau-Der Ho) ； 蔡顯揚(Hin-Yeung Tsai)

《Mid-Taiwan Journal of Medicine》 13卷4期 (2008/12) Pp. 186-193

https://doi.org/10.6558/MTJM.2008.13(4).3

摘要

背景／目的　提出罕見的六例中心性視網膜靜脈阻塞後並滲出性視網膜剝離之病例。並且討論中心性視網膜靜脈阻塞後並滲出性視網膜剝離之危險因子、視力預後及臨床特徵。
方法　回溯1996年到2001年轉介至林口長庚醫院之中心性視網膜靜脈阻塞後並滲出性視網膜剝離之病例。病例皆做過完整的眼部檢查，並每月回診追蹤。
結果　在符合診斷的六個病例中，其中五例是在中心性視網膜靜脈阻塞後二到六個月中發生滲出性視網膜剝離，而另依一病例則時間不確定。在五個病例中(83%)，滲出性視網膜剝離是位於下方，一個病例(17%)是在靠近視網膜的後極部處。有五個病例(83%)發生新生血管性青光眼或虹膜新生血管。另外，五個病例有高血壓病史，一例有高血脂症。全部病例皆有使用視網膜雷射治療。視力預後皆不佳，尤其發生新生血管性青光眼者視力僅有光感或無光感，其他沒發生新生血管性青光眼的病例視力也皆小餘零點零二。
結論　滲出性視網膜剝離是中心性視網膜靜脈阻塞後極少發生的併發症候。病人本身的血管性疾病及年紀較輕的病人可能是造成滲出性視網膜剝離的相關因子。病人視力預後不佳與新生血管性青光眼在此類病人的高發生率有關。

關鍵字

滲出性視網膜剝離 ； 中心性視網膜靜脈阻塞 ； 新生血管性青光

並列摘要

Background/Purpose. To investigate the risk factors, visual prognosis and characteristics of exudative retinal detachment in six patients with central retinal vein occlusion.
Methods. We retrospectively enrolled six patients in whom a diagnosis of exudative retinal detachment subsequent to central retinal vein occlusion was made during the period 1 July 1996 to 1 July 2001. All patients had undergone complete ophthalmic examinations including slit lamp, indirect ophthalmoscopy, intraocular pressure measurement, fluorescein angiography, and echographic studies and all patients were followed on a monthly basis.
Results. The time interval between the occurrence of vein occlusion and exudative retinal detachment ranged from two months to six months in five eyes, and was uncertain in one eye.
Exudative retinal detachment involved the inferior retina in five eyes (83%), and was near the posterior pole in one eye (17%). Neovascular glaucoma or rubeosis iridis developed in five eyes (83%). Five patients had a history of hypertension and one had a history of hyperlipidemia. Retinal photocoagulation was performed in each patient. The visual prognosis was very poor in the eyes with neovascular glaucoma (no light perception in two eyes, light perception in one eye), and poor in eyes without neovascular glaucoma (hand motion in one eye, counting fingers in one eye and 20/1000 in eye).
Conclusion. Massive exudative retinal detachment is a rare complication of central retinal vein occlusion. We found that there is a high incidence of neovascular glaucoma among patients with this condition.

並列關鍵字

central retinal vein occlusion ； exudative retinal detachment ； neovascular glaucoma