Objective To study clinical characteristics of ocular ischemic syndrome (OIS).Methods Retrospective study.Data,including sex,age,systemic diseases,best corrected visual acuity,anterior segment,fundus,fundus fluorescence angiography (FFA),transcranial Doppler (TCD) and digital subtraction angiography (DSA),were collected from 10 patients (12 eyes) with ocular ischemic syndrome from February 2008 to April 2009.Results The mean age was 59 years.There were six males and four females.All patients were combined with heart and/or cerebrovascular diseases.Best corrected visual acuity ranged from hand movement to 1.0.Neovascularization of the iris appeared in 5 eyes.Intraocular pressure over 21 mm Hg (1 mm Hg=0.133 kPa) was present in 3 eyes.Fundus examination showed narrow retinal arteries,dilated but not tortuous veins,fleck-shaped hemorrhage of the retina,cotton-wool exudates,optic disc edema,optic disc neovascularization,and atypical macular cherry-red spots.TCD showed stenosis of internal carotid artery at different degrees.FFA was performed in 9 patients which showed artery front,prolonged arm-retinal circulation time,retinal circulation time and choroid circulation time.All patients accepted vasodilation and microcirculation improving treatments.Visual acuity was improved at different degrees.One patient (2 eyes) with iris neovascularization was treated with retinal photocoagulation and the neovascularization disappeared after the treatment.There were 3 patients (3 eyes) had neovascular glaucoma.One patient was treated by ciliary cryotherapy.One patient was treated by retinal photocoagulation and internal carotid artery stent implantation and one were treated by internal carotid artery stent implantation.Four patients were examined by DSA.Internal carotid artery stent implantation was performed in 3 patients,subclavian artery stent implantation was performed in one patient and internal carotid artery intima decollement was performed in one patient.Conclusions Clinical manifestations of ocular ischemic syndrome patients are complicated which are depended on the different extents of ischemia.The management of ocular ischemic syndrome requires the collaboration of ophthalmologists,neurophysicians and neurosurgeons.%目的 探讨眼缺血综合征患者的临床特征.方法 回顾性系列病例研究.收集2008年2月至2009年4月收治的10例(12只眼)眼缺血综合征患者的临床资料,包括性别、年龄、全身病史、最佳矫正视力和眼前节、眼底、荧光素眼底血管造影(FFA)、经颅超声多普勒(TCD)、数字减影血管造影(DSA)等检查结果.结果 10例(12只眼)眼缺血综合征患者中,男性6例(6只眼),女性4例(6只眼);年龄55～66岁,平均59岁.患者均伴有心血管和(或)脑血管疾病.最佳矫正视力为手动至1.0,虹膜新生血管5只眼,眼压超过21 mm Hg(1 mm Hg=0.133 kPa)者3只眼.眼底表现为动脉细,静脉不同程度扩张但不迂曲,点片状视网膜出血和棉絮斑,视乳头水肿和新生血管,黄斑呈不典型樱桃红色.所有患者均行TCD检查,可见颈内动脉不同程度狭窄或闭塞.9例患者行FFA检查,均表现为动脉"前锋"现象,臂-视网膜循环时间、视网膜循环时间及脉络膜循环时间延长.所有患者均给予扩血管及改善微循环药物治疗,视力不同程度提高.虹膜新生血管5只眼中,2只眼行视网膜光凝,虹膜新生血管消退.继发新生血管性青光眼3只眼中,1只眼行睫状体冷冻术;1只眼行视网膜光凝及颈内动脉支架植入术,术后新牛血管消退,眼压控制正常;1只眼行颈内动脉支架植入术,术后眼压正常.4例行DSA检查,3例行颈内动脉支架植入术,1例行锁骨下动脉支架植入术,1例行颈内动脉内膜剥离术.结论 由于眼缺血综合征患者的缺血严重程度不一,眼部表现复杂多样,需要眼科医师联合神经内、外科医师共同诊治.
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