Pathophysiology and hemodynamics of branch retinal vein occlusion
Pathophysiology and hemodynamics of branch retinal vein occlusion
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DOI：
10.1016/s0161-6420(99)90483-9
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发表时间：
1999-11-01
期刊：
影响因子：
13.7
通讯作者：
Larsen, M
中科院分区：
文献类型：
--
作者：
Christoffersen, NLB;Larsen, M
目的：通过对一组视网膜分支静脉阻塞（BRVO）患者及相关视网膜血流异常的血管造影观察，描述与BRVO相关的病理生理学和血流动力学变化。设计：回顾性观察病例系列。参与者：共250例初发或显性BRVO患者和5例相关异常患者。彩色和无红色灰度眼底照相和静脉荧光素血管造影，主要结果措施：形态学迹象扰乱视网膜血流。结果：所有闭塞发生在动静脉交叉点，动脉位于静脉前。在动静脉交叉处血流的假定前兆异常包括湍流和上游静脉扩张。BRVO发作后，临床病程取决于BRVO相对于中心凹的位置、受累静脉引流区域的范围以及从静脉引流受损区域到邻近静脉引流完整区域的侧支引流能力。侧支成熟发生在BRVO发作后的6至24个月内，此时可以看到短暂的视网膜水肿，这是中心凹受累的优势，因为中心凹周围区域在相邻静脉引流区域之间具有最高密度的预形成侧支。BRVO的治疗可能受益于对侧支形成过程的精确血管造影分析和旨在加速侧枝成熟的过程。
Purpose: To describe the pathophysiologic and the hemodynamic changes associated with branch retinal vein occlusion (BRVO) on the basis of selected angiographic observations from a cohort of patients with BRVO and related anomalies of retinal blood flow.Design: Retrospective, observational case series.Participants: A total of 250 patients with incipient or manifest BRVO and 5 patients with related anomalies.Methods: Color and red-free gray-scale fundus photography and intravenous fluorescein angiography,Main Outcome Measures: Morphologic signs of disturbed retinal blood flow.Results: All occlusions occurred at arteriovenous crossing sites where the artery is positioned anterior to the vein. Presumptive precursor abnormalities of blood flow at arteriovenous crossings include turbulence and upstream venous dilation. After the onset of BRVO, the clinical course is determined by the location of the BRVO in relation to the fovea, the extent of the involved venous drainage area, and the collateral drainage capacity from the area with compromised venous drainage to the adjacent areas of intact venous drainage. Collateral maturation occurs over a period of 6 to 24 months after the onset of BRVO, when a transient retinal edema may be seen that has a preponderance for foveal involvement because the perifoveal area has the highest density of preformed collaterals between adjacent venous drainage areas.Conclusions: The treatment of BRVO may possibly benefit from a refined angiographic analysis of the process of collateral formation and new treatment methods aimed at accelerating the process of collateral maturation.