| Objective: Many generalized diseases ,as hypertension,arteriosclerosis ,diabetes mellitus ,hematopathy ,immune system diseases ,ocular local lesion as inflammation, trauma, degeneration can change retinal vascular ,result retinal vascular diseases. Some of these factors can impair inside and outside barrier of retina, and result vitreous hemorrhage. This article studied the related factors of retinal vascular diseases sight recovery pro- vitrectomy , so as to instruct clinical treatment and judge prognosis.Methods:121 cases (122 eyes) performing vitrectomy were included, which were diagnosed as vitreous hemorrhage by slit lamp,funduscope , bultrasound. Recording episode time, sight of pre and pro vitrectomy, complications and fluorescence fundus angiography. Including diabetic retinopathy 35 eyes(28.69%);central retinal vein occlusion 31eyes (25.41%);branch retinal vein occlusion 28 eyes(22.95%);Eales disease 18 eyes(14.75%);hypertension and arteriosclerosis retinopathy 10 eyes(8.20%). Different data were compared and analyzed statistically.Results: 1. sight pro-vitrectomy :light perception 3 eyes,hand movement 11 eyes,exponential 24 eyes,0.01-0.1 25 eyes,0.1-0.3 42 eyes,0.3 17eyes.35 eyes DR sight pro-vitrectomy, light perception-0.3 ；59 eyes RVO sight pro-vitrectomy, 0.01-0.7；18 eyes Eales disease sight pro-vitrectomy ,0.01-0.6；10 eyes hypertension and arteriosclerosis retinopathy sight pro-vitrectomy, light perception-0.5. 2.course and sight nondiabetic vitreous hemorrhage, group 1: 36 eyes(70.59%)sight above 0.1,group 2: 10 eyes(27.78%)sight above 0.1(P ＜0.01)。diabetic vitreous hemorrhage ,group1: 3 eyes(16.67%)sight above 0.1,group 2:10 eyes(58.82%)sight above 0.1 (P ＜0.05)。3.complications recurrent vitreous hemorrhage 12 eyes ,10 eyes(83.3%)sight below 0.1；cataract formation or cataract aggravation 9eyes ,5eyes(55.6%)sight below 0.1；IOP step-up 6 eyes,2 eyes(33.3%)sight below 0.1；uveitis 15 eyes ,3 eyes(20%)sight below 0.1；Retinal detachment 6eyes,6 eyes(100%)sight below 0.1。4 FFA. RCT between CRVO(27eyes) and BRVO(19eyes) had not a significant difference (P>0.05)；RCT of CRVO and sight were significance negative correlation (r=-0.67 P<0.01)；among RVO retinal capillary nonperfusion 22 eyes, 14 eyes(63.6%)sight below 0.1, 5eyes had occlusion of artery , 4 eyes sight below 0.1；between macula retinae and emphraxis branches there are drainage small vein in 8 eyes, sight all above 0.1, 5 eyes sight above 0.3,3 eyes had not lateral branch。Among 15 eyes Eales disease 13eyes had capillary nonperfusion, ,6 eyes had neovascular.4 eyes(66.7%)having nonvascular sight below 0.1。15 eyes DR had nonvascular, 8 eyes(53.3%)sight below 0.1；2 eyes cystoid macular edema,2 eyes(100%)sight below 0.1; 6 eyes had diabetic optic neuropathy,5 eyes(83.3%)sight below 0.1。Conclusions:1.Grasping indications and occasion could rise sight pro-vitrectomy. Retinal vascular diseases resulted vitreous hemorrhage, including proliferative diabetic retinopathy ,retinal vein emphraxis,Eales disease etc. Early vitrectomy treating vitreous hemorrhage could keep and ameliorate sight,prevent and reduce traction retinal detachment.。Early vitrectomy, fiber vascular tunic and retina adhered rarefactionly, so separation and shearing were easy; retina were thicker and elasrtic, not to easy to result iatrogenic hiatus; not having macula retinae function permanent alterations, benefiting to sight recovery. After 1 months drug treatment, nondiabetic vitreous hemorrhage hadn't utility, we should perform vitrectomy earlier. Diabetic vitreous hemorrhage hadn't utility and had retinal detachment, we should perform vitrectomy after 3 months. Retinal detachment should perform vitrectomy earlier. 2.Reducing complications should rise sight. There are iatrogenic hiatus,complicated cataract,recurrent vitreous hemorrhage,IOP step-up,infection ,etc. Following amelioration of medical facility,operation tools and technique , iatrogenic hiatus and infection... |
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