环状视网膜病变影像表现和病因分析

摘要

目的 探讨环状视网膜病变的临床影像学表现,分析其常见病因.方法 回顾性系列病例研究.分析2012年1月至2015年10月在河南省眼科研究所经眼底荧光血管造影确诊的466例环状视网膜病变患者的临床资料,分析其发病情况、常见病因、临床特征、相关检查和影像表现.结果 环状视网膜病变眼底表现为视网膜有一个或数个环形的黄白色的硬性渗出所组成的病变,其病源位于环的中心,眼底荧光素血管造影、吲哚青绿血管造影、光学相干断层扫描等影像检查表现特征明确,是鉴别和确定病因的根本.该466例病因构成为:糖尿病视网膜病变285例(61.2％),年龄相关性黄斑变性70例(15.0％),视网膜黄斑分支静脉阻塞48例(10.3％),Coats＇病35例(7.5％),视网膜大动脉瘤20例(4.3％),视网膜血管瘤5例(1.1％),黄斑部毛细血管扩张症2例(0.4％),息肉状脉络膜血管病变1例(0.2％).结论 环状视网膜病变是多种视网膜血管性病变的共同表现.对原发疾病的正确认识,选择相应的检查方法,有利于制定个体化的治疗方案,也可简化诊疗程序,提高诊治效率.%Objective To investigate the findings from the imaging and pathogenesis of circinate retinopathy.Methods This was a retrospective study.Four hundred and sixty-six patients who were diagnosed with circinate retinopathy with fundus angiography at Henan Eye Institute were enrolled.The disease etiology,clinical features and imaging characteristics were analyzed.Results Circinate retinopathy is characterized by one or several yellowish-white hard exudates enclosed in the lesion source,which show distinct imaging characteristics.Diabetic retinopathy (285/466,61.2％) was the most common cause of circinate retinopathy,followed by age-related macular degeneration (70/466,15.0％),branch retinal vein occlusion (48/466,10.3％),Coats＇ disease (35/466,7.5％),retinal macroaneurysm (20/466,4.3％),retinal angioma (5/466,1.1％),macular capillary expansion (2/466,0.4％) and polypoid choroid vascular lesions (1/466,0.2％).Conclusion Circinate retinopathy is a type of clinical manifestation that many retinal vascular diseases share.Therefore,an awareness of primary diseases can help to improve the diagnosis and treatment of circinate retinopathy.