Relationship Between Nerve Fiber Layer Hemorrhages and Outcomes in Central Retinal Vein Occlusion
Relationship Between Nerve Fiber Layer Hemorrhages and Outcomes in Central Retinal Vein Occlusion
复制标题
神经纤维层出血与视网膜中央静脉阻塞预后的关系
DOI：
10.1167/iovs.61.5.54
复制
发表时间：
2020
影响因子：
4.4
通讯作者：
D. Sarraf
中科院分区：
文献类型：
--
作者：
A. Au;A. Hilely;J. Scharf;F. Gunnemann;Derrick Wang;I. Chehaibou;Claudio Iovino;C. Grondin;Marie;K. Falavarjani;N. Phasukkijwatana;Marco Battista;E. Borrelli;R. Sacconi;Brittany Powell;Grant L. Hom;Tyler E. Greenlee;Thais F. Conti;G. Ledesma;M. Y. Teke;N. Choudhry;A. Fung;V. Krivosic;Jiwon Baek;M. Lee;Yoshimi Sugiura;G. Querques;E. Peiretti;R. Rosen;W. Lee;L. Yannuzzi;Dinah Zur;A. Loewenstein;D. Pauleikhoff;Rishi P. Singh;Y. Modi;J. Hubschman;M. Ip;S. Sadda;K. Freund;D. Sarraf
目的评价急性视网膜中央静脉阻塞（CRVO）患者视网膜出血的深度和类型，并将其与视力和解剖结果相关联。方法采用彩色眼底照相和荧光素血管造影对患者进行眼底检查，并进行随访。分析Snellen视力（VA）、中心凹厚度（CFT）、视网膜缺血程度和新生血管的发展。结果108例患者108眼进行了评价。平均年龄为63.6 ± 16.1岁，好发于右眼（73.1%）。平均随访17.2 ± 19.2个月。基线时的平均VA为20/126，最终随访时为20/80。血管周围神经纤维层（NFL）损伤的眼睛的基线（P = 0.005）和最终VA（P = 0.02）明显差于仅深损伤的眼睛。血管周围病变组的基线CFT（826 ± 394 µm）高于单纯深部病变组（455 ± 273 µm，P < 0.001）。10个视盘缺血区在血管周围型（80.0%）和视乳头周围型（31.3%）中的发生率明显高于单纯深部型（16.1%）（P < 0.001）。虹膜新生血管在乳头周围NFL组（14.3%）和血管周围NFL组（2.0%）与单纯深部NFL组（0.0%）中更常见，尽管这种差异不显著。结论：基线NFL视网膜病变与更严重的CRVO相关，伴有更严重的黄斑水肿，更差的视力结果，以及更大的缺血和新生血管形成风险。这可能与视网膜毛细血管丛的组织有关。CRVO视网膜病变的深度和分布模式可以提供一个容易识别的CRVO预后的早期生物标志物。
Purpose To evaluate the depth and pattern of retinal hemorrhage in acute central retinal vein occlusion (CRVO) and to correlate these with visual and anatomic outcomes. Methods Retinal hemorrhages were evaluated with color fundus photography and fluorescein angiography at baseline and follow-up. Snellen visual acuity (VA), central foveal thickness (CFT), extent of retinal ischemia, and development of neovascularization were analyzed. Results 108 eyes from 108 patients were evaluated. Mean age was 63.6 ± 16.1 years with a predilection for the right eye (73.1%). Average follow-up was 17.2 ± 19.2 months. Mean VA at baseline was 20/126 and 20/80 at final follow-up. Baseline (P = 0.005) and final VA (P = 0.02) in eyes with perivascular nerve fiber layer (NFL) hemorrhages were significantly worse than in eyes with deep hemorrhages alone. Baseline CFT was greater in the group with perivascular hemorrhages (826 ± 394 µm) compared to the group with deep hemorrhages alone (455 ± 273 µm, P < 0.001). The 10 disc areas of retinal ischemia was more common in patients with perivascular (80.0%) and peripapillary (31.3%) versus deep hemorrhages alone (16.1%, P < 0.001). Neovascularization of the iris was more common, although this differrence was not significant, in the groups with peripapillary (14.3%) and perivascular (2.0%) NFL versus deep hemorrhages alone (0.0%). Conclusions NFL retinal hemorrhages at baseline correlate with more severe forms of CRVO, with greater macular edema, poorer visual outcomes, and greater risk of ischemia and neovascularization. This may be related to the organization of the retinal capillary plexus. The depth and pattern of distribution of retinal hemorrhages in CRVO may provide an easily identifiable early biomarker of CRVO prognosis.
影响因子：
13.7
作者：
J. Clarkson;E. Chuang;D. Gass;M. Pedroso;T. Cubillas;E. S. Duria;D. Hess;I. Rams;M. Ball;A. Gutierrez;N. Muniz;J. Thompson;M. Pall;C. Pappas;D. Finkelstein;A. Patz;D. Rytel;J. Belt;D. Cain
通讯作者：
J. Clarkson;E. Chuang;D. Gass;M. Pedroso;T. Cubillas;E. S. Duria;D. Hess;I. Rams;M. Ball;A. Gutierrez;N. Muniz;J. Thompson;M. Pall;C. Pappas;D. Finkelstein;A. Patz;D. Rytel;J. Belt;D. Cain