非外伤性严重玻璃体积血主要病因回顾性分析

摘要

目的 观察非外伤性严重玻璃体积血患者的病因构成及变化趋势.方法 2005年1月至2011年12月行玻璃体切割手术治疗的非外伤性严重玻璃体积血患者1107例1202只眼纳入研究.按收治时间对患者进行分组,2005年1月至2008年12月为A组,2009年1月到2011年12月为B组.A组患者415例444只眼；B组患者692例758只眼.回顾分析引起玻璃体积血的病因构成及变化趋势.结果 A组444只眼中,视网膜静脉阻塞(RVO)156只眼、增生型糖尿病视网膜病变(PDR) 117只眼、视网膜裂孔或脱离(RH/RD) 61只眼、视网膜静脉周围炎(Eales病)42只眼、渗出型老年性黄斑变性(EAMD) 20只眼,占同期玻璃体积血患眼的89.19％；RVO患者比例最多.B组758只眼中,PDR 347只眼、RH/RD 135只眼、RVO 133只眼、Eales病29只眼、EAMD 22只眼,占同期玻璃体积血患眼的87.87％；PDR患者比例最多,RVO次之.PDR引起的玻璃体积血构成比逐年增加.结论 PDR、RVO、RH/RD、Eales病、EAMD是非外伤性严重玻璃体积血的常见原因；PDR引起的玻璃体积血呈增加趋势.%Objective To observe the etiological factors and variation of effects of non-traumatic severe vitreous hemorrhage.Methods A total of 1107 patients (1202 eyes) with non-traumatic severe vitreous hemorrhage who underwent vitrectomy from January 2005 to December 2011 were enrolled in this study.The patients were divided into A group (444 eyes of 415 patients were operated between January 2005 and December 2008) and group B (758 eyes of 692 patients between January 2009 and December 2011)according to admission date.The etiological factors and variations were recorded and retrospectively analyzed.Results Of all 444 eyes in group A,156 eyes were due to retinal vein occlusion (RVO),117 eyes associated with proliferative diabetic retinopathy (PDR),61 eyes with retinal hole/retinal detachment (RH/ RD),42 eyes with Eales disease,20 eyes with exudative age-related macular degeneration (EAMD).These diagnoses accounting for 89.19％ of the total eyes,were found to be the common causes in patients with severe vitreous hemorrhage,with RVO as the most common cause.Similarly in group B,severe vitreous hemorrhage was found in 347 eyes with proliferative diabetic retinopathy (PDR),135 eyes with retinal hole/ retinal detachment (RH/RD),133 eyes with retinal vein occlusion (RVO),25 eyes with Eales disease,22 eyes with exudative age-related macular degeneration (EAMD),accounting for 87.87 ％ of the total eyes.PDR was the most common cause instead of RVO to vitreous hemorrhage in this group.The number of vitreous hemorrhages increased year by year.Conclusions PDR,RH/RD,RVO,Eales disease and EAMD are the common causes of non-traumatic severe vitreous hemorrhage.There is a trend toward an increasing proportion of PDR among the causes of vitreous hemorrhage.