Objective To observe the clinical characteristics of multi-mode images of retinal arterial macroaneurysms and provide reference for the accurate diagnostic.Methods The clinic data of 24 patients (25 eyes) with retinal arterial macroaneurysms who were diagnosed in the First Affiliated Hospital of Zhengzhou University from August 2012 to May 2016 were retrospectively analyzed.All patients received ophthalmologic examinations including visual acuity,fundus photography,and fundus fluorescein angiography (FFA).The patients who could not be diagnosed by fundus photography and FFA underwent indocyanine green angiography (ICGA) and spectral-domain optical coherence tomography (SD-OCT) examinations.The visual acuity of the three types of retinal arterial macroaneurysms and the diameters of retinal arterial macroaneurysms based on FFA images was analyzed.Results A single macroaneurysm appeared in all the 25 eyes.Retinal arterial macroaneurysms of 22 eyes were on temporal artery branches and those of 3 eyes were on the nasal artery branches.Sixteen retinal arterial macroaneurysms were determined as hemorrhagic type,2 were exudative type and the other 7 were quiescent type.The difference of vision acuity in the three types of retinal arterial macroaneurysms was significantly different (x2=15.117,P=0.001).Retinal arterial macroaneurysms of 20 eyes could be clearly exhibited by FFA,and the retinal arterial macroaneurysms in other 5 eyes which were concealed due to bleeding were displayed by ICGA and OCT.The average diameter of retinal arterial macroaneurysms and normal arteries were (330.65±43.09)μm and (134.70±10.74)μm,respectively,showing a significant difference (t =21.034,P =0.000) and a positive correlation between them (r =0.867,P=0.000).Conclusions Most retinal artcrial macroaneurysms can be diagnosed by FFA,moreover,both ICGA and OCT can provide necessary supplement for the concealed retinal arterial macroaneurysms.The larger the diameter of the normal artery is,the larger the diameter of the corresponding retinal arterial macroaneurysms is.The typing of retinal arterial macroaneurysms can offer basis for the evaluation of management.%目的 分析视网膜大动脉瘤的多模式眼底影像特征,为视网膜大动脉瘤的准确诊断提供参考依据. 方法 回顾性分析2012年8月至2016年5月在郑州大学第一附属医院确诊的24例25眼视网膜大动脉瘤患者的临床资料.所有患者行视力测定、彩色眼底照相和荧光素眼底血管造影(FFA)检查,上述方法无法确诊的患者加行吲哚青绿跟底血管造影(ICGA)和频域光相干断层扫描(SD-OCT)检查.分析不同类型视网膜大动脉瘤患者的视力情况、FFA显示的瘤体直径和补充检查的影像特征. 结果 25眼均为单个瘤体.视网膜大动脉瘤位于颞侧动脉者22眼,鼻侧动脉者3眼.出血型视网膜大动脉瘤16眼,渗出型视网膜大动脉瘤2眼,静止型视网膜大动脉瘤7眼.3种不同类型视网膜大动脉瘤患者不同视力等级的眼数分布差异有统计学意义(x2=15.117,P=0.001).受检眼中20眼FFA影像中可见瘤体,FFA未发现的5眼中经ICGA和OCT可见瘤体.本组检测的平均瘤体直径为(330.65±43.09)μm,平均动脉直径为(134.70-±10.74) μm,二者间比较差异有统计学意义(t=21.034,P=0.000)且呈显著正相关(r=0.867,P=0.000). 结论 依据FFA可对多数视网膜大动脉瘤做出明确诊断,ICGA和OCT可对诊断做必要补充.位于较大直径正常动脉上的瘤体也较大.对视网膜大动脉瘤进行分型有助于对患者的治疗方案进行选择.
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