医源性眼部血管阻塞荧光血管造影分析.docVIP

医源性眼部血管阻塞荧光血管造影分析 　关键词：血管 　　【摘要】目的探讨医源性眼部血管阻塞的荧光血管造影(fundusfluoresceinangiography，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 　　FFAanalysisofexogenousocularvascularocclusion 　　【Abstract】ObjectiveToexplorethecharacteristicmanifestationofFFAofexogenousvascularocclusion.Methods9eyesof9patientswerephotographed.ResultsOf9patientswithexogenousmedicalhistorydefinitely，4patientswerediagnosedcentralretinalarteryocclusion.FFAshowedthatcentralretinalarteryandveinperfusedslowlyduringearlystagewithfillingdefectofparafovealarteriolebeforecapillary，theopticdiskshowedhyperfluorescenceduringlatestage.4patientswerediagnosedthecentralretinalarteryocclusionwithcentralretinalveinocclusion.FFAshowedthatcentralretinalveinperfusedslowly，posteriorpolehasmanypiecesofhypofluorescenceblock，thefovealvasculararchwasdestroyedwithfillingdefectofperipheralarteriolebeforecapillaryandtherewereextensivenonperfusionareasattheposteriorpoleandperipheralareas；1patientwasdiagnosedoculararteryocclusion.FFAshowedthatchoroidalbackgroundfluorescenceandcentralarterywereperfusedslowly，thevascularfluorescenceperfusionwasinterruptedbeforeopticdiskandtheperfusioninterruptioncontinueduntillatestagewithextensiveperipheralnonperfusionareas.ConclusionExogenousocularvascularblockcancausecentralretinalarteryocclusion，centralretinalarteryocclusionwithcentralretinalveinocclusionandoculararteryocclusion.Thesediseasesareverysevereandtheblockareaisveryextensive.ThoughmanifestationofFFAisdifferent，theetiologyandmechanismaresimilar.Itisveryimportanttodifferentiateitfromothersinclinical. 　　【Keywords】exogenousocularvascularocclusion;fundusfluoresceinangiography 　眼部血管阻塞是眼科危重急症，表现为急性视力丧失和视野缺损。我院对2002~2005年期间，有明确医