Laser-induced chorioretinal venous anastomosis for nonischemic central retinal vein occlusion: Evaluation of the complications and their risk factors
Laser-induced chorioretinal venous anastomosis for nonischemic central retinal vein occlusion: Evaluation of the complications and their risk factors
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DOI：
10.1016/s0002-9394(98)00156-1
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发表时间：
1998-08-01
影响因子：
4.2
通讯作者：
Yu, DY
中科院分区：
文献类型：
--
作者：
Mcallister, IL;Douglas, JP;Yu, DY
目的：评价激光诱导视网膜脉络膜静脉吻合治疗非缺血性视网膜中央静脉闭塞（CRVO）的并发症及相关危险因素。方法：回顾性分析91只眼（91例患者）的非缺血性CRVO，平均+/- SD持续时间为15.0 +/- 15.2周（范围3至72周），矫正视力因灌注性黄斑水肿降至20/100以下。所有眼均采用氩激光（46眼联合Nd-YAG激光）进行一次或多次吻合尝试，随访至少12个月。结果：巩膜视网膜静脉吻合术成功49眼（54%），新血管并发症18眼（20%）。这些包括玻璃体内、视网膜内和视网膜下新生血管膜，并与视网膜缺血显著相关（P < 0.001）。8只眼（9%）出现吻合部位无血管纤维组织增生，且与视网膜缺血无关（P = 0.127）；吻合功能恢复后，没有眼出现进一步的毛细血管非灌注；84%的眼睛的平均SD改善了4.3 +/- 3.8线（范围，2至20线），其余16%的眼睛没有改善或视力下降。结论：激光诱导脉络膜视网膜静脉吻合术治疗非缺血性CRVO的主要视力威胁并发症是吻合部位出现新生血管膜；这些都与视网膜缺血有关，对吻合后发生的视网膜缺血区域及时进行激光光凝可以降低这种并发症的风险和严重程度。[J]中华眼科杂志，1998;32(3):391 - 391。(C) 1998年Elsevier Science Inc。版权所有)。
PURPOSE: To evaluate the complications of laser induced chorioretinal venous anastomosis in nonischemic central retinal vein occlusion (CRVO) and to identify the associated risks.METHODS: A retrospective consecutive series of 91 eyes (91 patients) with nonischemic CRVO with a mean +/- SD duration of 15.0 +/- 15.2 weeks (range, 3 to 72 weeks) and corrected visual acuity reduced to 20/100 or less because of perfused macular edema were reviewed. All eyes had one or more anastomotic attempts using argon laser (combined with Nd-YAG laser in 46 eyes) and a minimum of 12 months of follow up.RESULTS: Successful chorioretinal venous anastomoses were created in 49 eyes (54%), Eighteen eyes (20%) had neovascular complications. These consisted of intravitreal, intraretinal, and subretinal neovascular membranes and were significantly associated with retinal ischemia (P < .001). There was avascular fibrous tissue proliferation at the anastomotic site in eight eyes (9%), and it was not associated with retinal ischemia (P = .127), No eye developed further capillary nonperfusion once an anastomosis became functional, A chorioretinal venous anastomosis was associated with improved vision (P < .001); 84% of eyes had an average SD improvement of 4.3 +/- 3.8 lines (range, 2 to 20 lines), with the remaining 16% having no improvement or reduced vision.CONCLUSION: The major vision-threatening complication of laser-induced chorioretinal venous anastomosis for nonischemic CRVO is neovascular membranes occurring at the anastomotic site; these are associated with retinal ischemia, Prompt laser photocoagulation to areas of retinal ischemia that develop after the anastomotic attempt has been made may reduce the risk and severity of this complication. (Am J Ophthalmol 1998;126: 219-229. (C) 1998 by Elsevier Science Inc. All rights reserved.).