| Objective: This study focused on the main etiology of hemorrhagic retinal detachment with vitreous hemorrhage,and analyzed the B-ultrasound features of hemorrhagic retinal detachment caused by different causes,and provided patients assistance for treatment options,prognosis and efficacy evaluation..Methods:Collection of Anhui Provincial Hospital from July 2015 to August 2017,admitted to hospital for diagnosis of vitreous hemorrhage,Preoperatively record the patient's age,gender,course of disease,systemic disease(such as hypertension,diabetes,etc.),best corrected visual acuity,light localization,slit lamp microscope to observe the anterior segment of the eye,non-contact tonometer to check intraocular pressure.Preoperative ophthalmologic B-ultrasound observation of the morphology,location,extent,and echo intensity of the retina,equatorial,and peripheral parts.All patients underwent vitrectomy,and the retinal condition was observed during the operation.None of the patients with subretinal hemorrhage had undergone subretinal hemorrhage or neovascularization removed.Postoperative patients completed the fundus photography,partially improved FFA and ICGA definitive diagnosis,some patients did not undergo angiography due to systemic factors,diagnosed by three experienced fundus doctors.The preoperative ophthalmologic B-ultrasound showed hemorrhagic retinal detachment and the intraoperative verification results were compared,and the B-ultrasound imaging features and clinical features wereanalyzed.Comparing the difference between the best corrected visual acuity and the best corrected visual acuity after surgery,the visual acuity was converted into LOGMAR value(3.0 means finger count,2.0 means hand move,1.0 means light perception),and the paired sample t test was used,P<0.05.The difference was statistically significant?Results: The causes of vitreous hemorrhage were as follows: 201 cases of diabetic retinopathy(DR),accounting for 60.1%,98 cases of branch retinal vein occlusion(BRVO),accounting for 29.3%,6 cases of central retinal vein occlusion(CRVO),accounting for 1.79%,3 cases of retinal aortic aneurysm(RAM),accounting for 0.89 %,5 cases of retinal vasculitis,accounting for 1.49%,4 cases of Terson's syndrome(TS),accounting for 1.19%,5 cases of age-related macular degeneration(AMD),accounting for 1.49%,12 cases of polypoid choroidal vasculopathy(PCV),accounting for 3.59%.Preoperative B-ultrasound results showed 28 cases of hemorrhagic retinal detachment,and 16 cases of hemorrhagic retinal detachment(HRD)were confirmed by operation.306 cases of preoperative B-ultrasound did not suggest HRD,and 6cases of HRD were found by surgery.Among all HRD patients,there are 12 cases of PCV,5 cases of AMD,2 cases of RAM,and3 case of DR.There was significant difference between postoperative BCVA and preoperative BCVA in PCV(P=0.039).There was significant difference between postoperative BCVA and preoperative BCVA in AMD(P=0.027).The difference between postoperative BCVA and preoperative BCVA in DR Statistically significant(P=0.040);Terson's syndrome postoperative BCVA was significantly different from preoperative BCVA(P=0.016);there was no significant difference in postoperative BCVA between RAM and preoperative BCVA(P=0.226).The main ultrasound features a strong echogenic image of the retina strip connected to the optic disc,and a flat arc echo ridge with a point echo.Ultrasound examination has high sensitivity andspecificity,80% and 96.2%,respectively.Conclusion:B-ultrasound is an important means to evaluate the posterior segment of the eye in the case of refractive interstitial opacity such as vitreous hemorrhage.We believe that B-ultrasound can effectively display subretinal hemorrhage,and combined with the patient's medical history,can accurately judge its prognosis.Even in patients with subretinal hemorrhage,surgical treatment allows most patients to improve part of their vision and improve visual function. |
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