periretinal phlebitis
Introduction
Introduction to retinal vein inflammation The central retinal artery is the terminal artery, and its obstruction causes acute ischemia of the retina, and the visual acuity is seriously degraded, which is one of the blind emergencies. The ciliary vascular system has traffic with each other, so obstructive disorders are rare. If the ophthalmic artery is obstructed, its branching of the central retinal artery and the posterior ciliary artery will cause the inner and outer layers of the retina to be completely severed, and the blindness rate is higher and the consequences are more serious. basic knowledge The proportion of illness: 0.003% Susceptible people: no specific population Mode of infection: non-infectious Complications: glaucoma retinal detachment
Cause
Causes of retinal vein inflammation
The etiology of this disease is diverse, and tuberculosis infection has been recognized by most scholars. Its pathogenesis, except for a small number of tuberculosis, is directly caused by blood or local spread, in most cases, it is caused by tuberculin. Type III allergic reaction, no active tuberculosis in the whole body and eye treatment, or only old lesions (such as lung, hilar calcification), tuberculin skin test strong positive, and can induce focal reaction Retinal vein inflammation and vitreous hemorrhage suddenly aggravated, sepsis lesions, such as chronic tonsillitis, dental caries, skin abscess, etc., is also a common cause of this disease, in addition, thromboangiitis obliterans, tsutsugamushi, syphilis , sarcoidosis, Behcet syndrome, etc., have also reported this disease.
Prevention
Retinal vein inflammation prevention
The prognosis of the disease depends on whether the macula is damaged or not, and whether traction retinal detachment occurs. Glass with more blood, or repeated recurrence, the general prognosis is poor. However, as long as the macula is not damaged, the visual acuity can be restored to the original level or close to the original level during the accumulation of blood and the diseased vein. Conversely, if the macula is involved, even if the bleeding is rare, or only the first time, the vision is irreversible. A large amount of blood in the vitreous body, especially the vitreous hemorrhage after recurrent episodes, is often not easy to disappear, and finally becomes proliferative to form proliferative vitreoretinopathy, or connective tissue contraction, causing traction retinal detachment, and poor prognosis.
Complication
Complications of retinal vein inflammation Complications glaucoma retinal detachment
1. A large amount of blood in the vitreous cavity causes a sudden decrease or complete loss of vision, and can be followed by glaucoma.
2. Late stage can cause secondary retinal detachment.
Symptom
Symptoms of inflammation around the retinal vein Common symptoms Retinal hemorrhage Retinal edema Retinal Roth plaque Retinal detachment
Most of the disease involves both eyes, but the severity of the two eyes and the frequency of recurrence are not consistent. If there is a large amount of vitreous hemorrhage in the eye, if the eye is not able to be examined, the eye should be fully dilated and examined, such as in the periphery of the fundus. Seeing one or several small branches of the vein filling, twisting, bleeding or oozing nearby, white sheath or turbidity of the venous wall can be used as a clinical diagnosis argument for this open door.
As far as the cause is concerned, it should be as clear as possible to make the treatment targeted, and comprehensive physical examination and necessary laboratory examinations, such as chest fluoroscopy or radiography, for tuberculosis or sarcoidosis, skin, oral cavity, otolaryngology examination. There are no septic lesions or shallow ulcers, anti-"O", syphilis rapid plasma reagin test, blood, urine routine.
Because the disease is mostly caused by tuberculosis allergies, the Mantoux test seems to be required in theory, but in fact it is not necessary, because the skin test is positive, it does not mean that the eye disease is caused by tuberculosis, only the lesion is positive. According to the fact that the disease is sufficient, and a lesion reaction may cause the disease to deteriorate rapidly and the vision is devastating, so as long as the patient has a history of tuberculosis or a systemic inactive tuberculosis (such as a hilar or pulmonary calcification), If you can't find other suspicious causes after various tests, you can infer that even if you can't prove tuberculosis, you can also make a one-stage diagnostic anti-tuberculosis treatment, depending on the function damage, the size of the affected blood vessels, the amount of bleeding and the location. If the lesion is located in the blood vessels around the fundus, the amount of bleeding is small, the patient has no self-conscious symptoms or only mosquitoes; when the lesion is located in a larger vein, the amount of bleeding is more, breaking through the internal boundary membrane into the vitreous, or bleeding If you are in the macula, your eyesight will suddenly drop. In severe cases, you can suddenly drop to the immediate index, manual, and even light.
Examine
Examination of retinal vein inflammation
1. Fundus fluorescein angiography.
2. Whole body examination: chest X-ray examination, tuberculin test, blood test, immunological examination, etc.
Diagnosis
Diagnosis and differentiation of retinal vein inflammation
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
1. Anterior ischemic optic neuropathy: often both eyes have a history of onset, the fundus shows obvious edema of the optic papilla, mild or moderate visual acuity, and the typical damage of the visual field is a curved dark spot connected to the physiological blind spot.
2. Ocular artery obstruction: visual function damage is more serious, vision is usually light or no light. Reduced intraocular pressure, retinal edema is more serious, and there can be no "cherry red" in the macular area.
