小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 突发性、无痛性视力严重下降
- 视盘水肿
- 视网膜出血
- 静脉迂曲扩张
- 侧支循环形成
其他诊断因素
- 年龄＞ 65 岁
- 新生血管形成
- 玻璃体出血
- 黄斑水肿
- 飞蚊症
- 眼痛，红眼
- 视力
- 相对性传入性瞳孔反应障碍
- 眼压升高
危险因素
- 动脉粥样硬化
- 体循环高血压
- 糖尿病
- 高甘油三酯血症
- 吸烟史
- 心血管疾病
- 青光眼
- 20岁体重指数增加
- 血清α-2丙种球蛋白升高
- 眼轴短
- 年龄＞ 65 岁
- 活化蛋白C抵抗
- 凝血因子 V Leiden
- 血液高凝状态
- 蛋白 S 缺陷
- 抗凝血酶 III 缺陷
- 高同型半胱氨酸血症
- 血管炎
诊断性检查
首要检查
- 荧光素眼底血管造影确诊
需考虑的检查
- 荧光素眼底血管造影评估并发症
- 光学相干断层扫描
- 视网膜电流图
治疗流程
CRVO：单纯性
CRVO并发黄斑水肿
CRVO并发新生血管形成
BRVO或HRVO：单纯性
BRVO或HRVO并发黄斑水肿
BRVO或CRVO并发新生血管
撰稿人
作者
Aziz A. Khanifar, MD
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.
鉴别诊断
- 缺血性视神经病变
- 视网膜脱离
- 脉络膜新生血管（CNV）
更多 鉴别诊断指南
- 视网膜摘要基准 - 2023 年
- 视网膜静脉阻塞 (RVO) 指南 (Retinal vein occlusion (RVO) guidelines)
更多 指南患者教育信息
糖尿病：如何保持健康？
青光眼（开角型）
更多 患者教育信息
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明