山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (4): 41-47.doi: 10.6040/j.issn.1673-3770.1.2020.050

• 眼缺血综合征多学科精准诊疗 临床研究 • 上一篇    下一篇

25例虹膜新生血管发生原因探讨

李萱1,2, 黄映湘2   

  1. 李萱1, 2, 黄映湘21. 首都医科大学附属北京友谊医院 眼科, 北京 100050;
    2. 中国中医科学院眼科医院 眼底病眼外伤科, 北京 100040
  • 收稿日期:2020-05-26 出版日期:2020-07-20 发布日期:2020-08-28
  • 作者简介:李萱. 现在中国中医科学院眼科医院眼底病眼外伤科工作.
  • 基金资助:
    北京市卫生系统高层次卫生技术人才培养计划(2014-3-007)

Case analysis of 25 cases of iris neovascularizationLI Xuan1,2, HUANG Yingxiang2 1. Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China; 2. Department of Fundus Disease and Eye Trauma, Eye Hospital China Academy of Chinese Medicine Sciences, Beijing 100040, ChinaAbstract:

ObjectiveTo discuss the causes and appropriate treatment for iris neovascularization following the analysis of 25 cases(28 eyes). MethodsIt was a retrospective case series study involving 25 patients(28 eyes)with iris neovascularization diagnosed between September 2014 and July 2016. All the patients underwent ophthalmic examination, and all the examination findings and treatments were recorded. The causes, correlative factors, and treatment outcomes of iris neovascularization were analyzed. ResultsOf the patients, 17(20 eyes, 71.4%)had retinal ischemic signs, including vitreous hemorrhage and retinal vascularization on fundus fluorescein angiography; 8(8 eyes, 28.6%)did not have retinal ischemic signs. After 3 months of treatment, retinal vascularization resolved in all the cases, and iris neovascularization resolved completely in 20 patients(23 eyes, 82.1%), iris neovascularization was still found in 5 patients(5 eyes, 17.9%). ConclusionsAnterior segment ischemia may also lead to iris vascularization, although retinal ischemia was the main cause. Additionally, iris neovascularization may not always resolve with treatment for retinal ischemia. Finally, anti-VEGF drug injection was an effective treatment for iris neovascularization.   

  1. Key words:Glaucoma, Neovascular;
    Retinal Vascularization;
    Vascular Endothelial Growth Factors 虹膜新生血管(neovascularization of the iris, NVI)是继发于多种眼病的一种特有体征, 可以导致新生血管性青光眼(neovascular glaucoma, NVG)发生［1］。以往研究［2］认为, 视网膜缺血、缺氧, 产生血管内皮生长因子(vascular endothelial growth factors, VEGF)是导致NVI生长的原因, 主要通过全视网膜光凝术(panretinal photocoagulation, PRP), 改善视网膜缺血、消退NVI, 从而治疗或预防新生血管性青光眼。本研究对2014年9月至2016年7月期间就诊于北京友谊医院眼科的25例(28眼)发现NVI的患者, 进行回顾性研究, 探讨引起NVI生长的原因及有效的治疗方法。
  • Received:2020-05-26 Online:2020-07-20 Published:2020-08-28

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261

摘要： 目的 分析25例(28眼)虹膜新生血管生长原因,探讨消除虹膜新生血管的有效方法。 方法 回顾性分析2014年9月至2016年7月期间临床发现虹膜新生血管的患者25例(28眼)眼部相关检查资料,记录治疗方法及病情变化,分析虹膜新生血管发生的原因及治疗效果。 结果 25例(28眼)治疗前裂隙灯下均可见虹膜新生血管;17例(20眼,71.4%)存在视网膜缺血表现,包括FFA可见视网膜新生血管或大片非灌注区,或存在大量的玻璃体积血及纤维血管增殖膜;8例(8眼,28.6%)缺乏视网膜缺血相关表现。治疗后3个月,FFA显示25例(28眼)均未见视网膜新生血管;20例(23眼,82.1%)虹膜新生血管消退,5例(5眼,17.9%)虹膜新生血管未完全消退。 结论 眼前部缺血也是虹膜新生血管发生的原因之一;全视网膜光凝术是针对视网膜缺血的治疗手段,不能消除全部的虹膜新生血管,抗VEGF药物注射对虹膜新生血管有很好的疗效。

关键词: 青光眼,新生血管性, 视网膜新生血管化, 血管内皮生长因子

Abstract: Objective To discuss the causes and appropriate treatment for iris neovascularization following the analysis of 25 cases(28 eyes). Methods It was a retrospective case series study involving 25 patients(28 eyes)with iris neovascularization diagnosed between September 2014 and July 2016. All the patients underwent ophthalmic examination, and all the examination findings and treatments were recorded. The causes, correlative factors, and treatment outcomes of iris neovascularization were analyzed. Results Of the patients, 17(20 eyes, 71.4%)had retinal ischemic signs, including vitreous hemorrhage and retinal vascularization on fundus fluorescein angiography; 8(8 eyes, 28.6%)did not have retinal ischemic signs. After 3 months of treatment, retinal vascularization resolved in all the cases, and iris neovascularization resolved completely in 20 patients(23 eyes, 82.1%), iris neovascularization was still found in 5 patients(5 eyes, 17.9%). Conclusions Anterior segment ischemia may also lead to iris vascularization, although retinal ischemia was the main cause. Additionally, iris neovascularization may not always resolve with treatment for retinal ischemia. Finally, anti-VEGF drug injection was an effective treatment for iris neovascularization.

Key words: Glaucoma, Neovascular, Retinal Vascularization, Vascular Endothelial Growth Factors

中图分类号: 

  • R773.1
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