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Oclusão da veia retiniana

最后审阅: 16 Aug 2025
最后更新: 09 Jul 2024

小结

定义

病史和体格检查

关键诊断因素

  • presença de fatores de risco
  • perda da visão súbita e indolor
  • edema da cabeça do nervo óptico
  • hemorragia intrarretiniana
  • tortuosidade e dilatação venosas
  • formação de vasos colaterais
完整详情

其他诊断因素

  • idade >65 anos
  • neovascularização
  • hemorragia do vítreo
  • edema macular
  • moscas volantes
  • olho dolorido e vermelho
  • acuidade visual
  • defeito pupilar aferente relativo
  • pressão intraocular elevada
完整详情

危险因素

  • aterosclerose
  • hipertensão sistêmica
  • diabetes mellitus
  • hiperlipidemia
  • história de tabagismo
  • doença cardiovascular
  • glaucoma
  • índice de massa corporal aumentado aos 20 anos de idade
  • aumento de alfa-2-globulina sérica
  • comprimento axial curto
  • idade >65 anos
  • resistência à proteína C ativada
  • fator V de Leiden
  • estado hipercoagulável
  • deficiência de proteína S
  • deficiência de antitrombina III
  • hiper-homocisteinemia
  • vasculite
完整详情

诊断性检查

首要检查

  • angiografia com fluoresceína para confirmação do diagnóstico
完整详情

需考虑的检查

  • angiografia com fluoresceína para avaliação de complicações
  • tomografia de coerência óptica
  • eletrorretinografia
完整详情

治疗流程

急症处理

OVRC: não complicada

oclusão da veia retiniana central (OVRC) com edema macular

OVRC com neovascularização

ORVR ou OVHR: não complicada

oclusão de ramo da veia retiniana (ORVR) ou oclusão da veia hemirretiniana (OVHR) com edema macular

oclusão de ramo da veia retiniana (ORVR) ou oclusão da veia hemirretiniana (OVHR) com neovascularização

撰稿人

作者

Aziz A. Khanifar, MD
Aziz A. Khanifar

Vitreoretinal Surgeon

The Retina Group of Washington

Silver Spring

MD

利益声明

AAK has been reimbursed by Genentech, Regeneron and Iveric Bio.

鸣谢

Dr Aziz A. Khanifar would like to gratefully acknowledge Dr Sharon Fekrat, a previous contributor to this topic.

利益声明

SF declares that she has no competing interests.

同行评议者

Stephen G. Schwartz, MD

Assistant Professor of Clinical Ophthalmology

Bascom Palmer Eye Institute

University of Miami Miller School of Medicine

Naples

FL

利益声明

SGS has received research funding from Alcon, Genentech, and Novartis; holds equity in Pfizer; and is co-holder of a patent pending entitled "Molecular targets for modulating intraocular pressure and differentiation of steroid responders from non-responders".

Tim Murray, MD

Professor of Ophthalmology

Bascom Palmer Eye Institute

University of Miami Miller School of Medicine

Naples

FL

利益声明

TM declares that he has no competing interests.

Alexander Spratt, MBBCh, MRCOphth

Specialist Registrar

Moorfields Eye Hospital

Visiting Lecturer

City University

London

UK

利益声明

AS has received research funding from Allergan.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Romano F, Lamanna F, Gabrielle PH, et al. Update on retinal vein occlusion. Asia Pac J Ophthalmol (Phila). 2023 Mar-Apr;12(2):196-210.全文  摘要

The Royal College of Opthalmologists. Retinal vein occlusion guidelines. Feb 2022 [internet publication].全文

Flaxel CJ, Adelman RA, Bailey ST, et al. Retinal vein occlusions preferred practice pattern®. Ophthalmology. 2020 Feb;127(2):P288-320.全文  摘要

Nicholson L, Talks SJ, Amoaku W, et al. Retinal vein occlusion (RVO) guideline: executive summary. Eye (Lond). 2022 May;36(5):909-12.全文  摘要

Shalchi Z, Mahroo O, Bunce C, et al. Anti-vascular endothelial growth factor for macular oedema secondary to branch retinal vein occlusion. Cochrane Database Syst Rev. 2020 Jul 7;7:CD009510.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Oclusão da veia retiniana images
  • 鉴别诊断

    • Neuropatia óptica isquêmica
    • Descolamento da retina (DR)
    • Neovascularização da coroide (NVC)
    更多 鉴别诊断
  • 指南

    • Retina summary benchmarks - 2023
    • Retinal vein occlusion (RVO) guidelines
    更多 指南
  • 患者教育信息

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