视网膜分枝静脉阻塞(BRVO) 是一种以静脉阻塞引起的眼底血管疾病,表现为阻塞静脉远端呈迂曲扩张,阻塞静脉附近视网膜出血、水肿、渗出, 累及黄斑部者可严重影响视力。Leber (1877) 首次报道了这一疾病,并描述了其眼底改变。BRVO 在临床上较常见,其发病率在眼底疾病中占第二位,仅次于糖尿病性视网膜病变。

1.Hypertension is the major risk factor
2.Vision loss less devastating
3.Major complication is macular edema
4.Some vision loss due to edema can be treated with laser

高血压病史、心血管疾病史、高体重指数、青光眼病史、α2 球蛋白偏高等,并指出心血管因素是主要的,50 %的BRVO可归因于高血压。Green 等认为,BRVO危险因素可分为两类:全身性原因和局部原因。全身性原因主要有高血压、心2脑血管病变、高血脂、糖尿病及各种原因引起的血小板减少症等;局部原因主要有开角型青光眼、视乳头水肿、硬脑膜下出血、视神经管内出血、视盘玻璃疣等。

Most people know high blood pressure and other vascular diseases pose risks to overall health, but many may not know that high blood pressure can affect vision by damaging veins in the eye. High blood pressure is the most common condition associated with BRVO. About 10 to 12 percent of the people who have BRVO also have glaucoma (high pressure in the eye). Other risk factors for BRVO include diabetes and hardening of the arteries.

Branch retinal vein occlusion blocks small veins in the retina, the layer of light-sensing cells at the back of the eye. If the blocked retinal veins are ones that nourish the macula, the part of the retina responsible for straight-ahead vision, some central vision is lost. During the course of vein occlusion, sixty percent or greater will have swelling of the central macular vision area. In about one third of people, this macular edema will remain for over one year.

BRVO causes a painless decrease in vision, resulting in misty or distorted vision. If the veins cover a large area, new abnormal vessels may grow on the retinal surface, which can bleed into the eye and cause blurred vision.

There is no cure for BRVO. Finding out what caused the blockage is the first step in treatment. Your ophthalmologist may recommend a period of observation, since hemorrhages and excess fluid may subside on their own. Depending on how damaged the veins are, laser surgery may help reduce the swelling and improve vision. Laser surgery may also shrink the abnormal new blood vessels that are at risk of bleeding.

Treatment of underlying risk factors like high blood pressure, glaucoma oar diabetes is also important.

激光对于预防黄斑水肿、新生血管和玻璃体出血有肯定的疗效,但对视力提高帮助不大。

BRVO 多见于颞上方,其次为颞下方,鼻侧少见。。BRVO 多数发生于动静脉交叉处,此处动静脉由一共同的鞘膜包裹,当动脉管壁硬化增厚或鞘膜增厚时,均可导致静脉压迫,造成静脉管腔狭窄,血流速度和性状改变,继而引起管壁内皮肿胀、坏死和出血, 诱发栓塞。

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