目的 探讨眼缺血综合征(OIS)的病因及危险因素、临床表现、眼底血管荧光造影检查、诊断及治疗、并发症和预后,提高对该综合征的认识和早期诊断率.方法 收集2013年6月至2016年6月在西安市第四医院眼科确诊的16例(30只眼)眼缺血综合征患者临床资料,进行回顾性分析.对所有患者进行病史采集、视力检查、裂隙灯显微镜、眼底照相、视网膜血管荧光造影(FFA)、彩色超声多普勒成像(CDFI)检查,部分患者行磁共振血管成像(MRV)、CT血管造影(CTA)及数字减影血管造影(DSA)检查.结果 16例患者中男性9例,女性7例,平均年龄(60.5±5.5)岁,主要病因多见于颈内动脉狭窄及心脑血管疾病.本组患者2例出现一过性黑朦,11例表现为视力下降,3例表现为眼疼痛.球结膜水肿、角膜上皮和实质水肿3例,前房浮游细胞、房闪阳性1例,虹膜和前房角新生血管4例.22只眼眼底出现了中周部视网膜散在出血,20只眼见视网膜静脉扩张,29只眼表现为动脉狭窄变细.FFA表现为所有患者臂-视网膜循环时间延长和动静脉循环时间延长.结论 OIS属于多学科交叉疾病,患者预后差,应加强对该病的认识,早期诊断早期治疗,积极控制危险因素及并发症是决定OIS预后的关键.%Objective To investigate the etiology and risk factors,clinical manifestations,fundus fluorescein angiography,diagnosis and treatment,complications and prognosis of ocular ischemic syndrome (OIS),and to improve the understanding and early diagnosis rate of this syndrome.Methods The clinical data of 16 patients (30 eyes) with ischemic syndrome diagnosed in our hospital from June 2013 to June 2016 were retrospectively analyzed.Fundus fluorescein angiography (FFA),color Doppler ultrasonography (CDFI),and Magnetic resonance Vein (MRV),CT angiography (CTA) and digital subtraction angiography (DSA) were supported the diagnosis.All patients were examined by pathology,visual examination,slit lamp microscope,fundus photography,and FFA.Results Among the 16 patients,9 were male and 7 were female.The patients' mean age at the time of onset was 60.5 years old (age ranged 60.5±5.5).The main causes were cervical stenosis,cardiovascular and cerebrovascular diseases.Amaurosis fugax was occurred in 2 cases,decreased vision in 11 cases,and eye pain in 3 cases.Conjunctival edema,corneal epithelium and parenchymal edema were observed in 3 cases,anterior chamber placental cells and atrial flash in 1 case,and iris combined with anterior chamber angle neovascularization in 4 cases.Fundus examination showed narrow retinal arteries (29 eyes),dilated but not tortuous veins (20 eyes),and fleck-shaped hemorrhaged of the retina (22 eyes).FFA was performed which showed prolonged arm-retinal circulation time (22.16± 6.46 s) and retinal arterial-venous circulation time (14.02 ± 7.26s) in all patients,artery front in 15 eyes,and nonperfusion with peripheral retinal in 6 eyes.CDFI examination showed internal carotid atherosclerotic plaque in 15 cases,internal carotid artery stenosis in 13 cases,internal carotid artery occlusion in 1 case,and internal carotid artery central resistance index slightly increased in 6 cases.Conclusions Clinical manifestations of ocular ischemic syndrome patients are complicated which are depended on the different extents of ischemia.The prognosis of this syndrome is poor.Early diagnosis,early treatment,active control of risk factors and management of complications are the key to determine the prognosis of this disease.
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