摘要目的 探讨出血性埋藏性视盘玻璃疣的临床特征.方法 回顾性分析于2009年6月至2013年6月在河北医大第二医院眼科就诊的38例伴有视盘表面出血、视网膜深层出血和(或)视网膜前(玻璃体)出血,经眼底照相、FFA、SD-OCT检查确诊的埋藏性视盘玻璃疣的临床资料,总结其临床特征.结果 38例患者均有视力下降、眼前黑影遮挡等临床表现.38例患者均可见视盘表面和视盘鼻侧视网膜深层出血,其中8例还见视网膜前(玻璃体)出血.23例患者FFA表现为典型的视盘鼻侧晚期结节样高荧光.38例患者SD-OCT视盘鼻侧边缘均有团状中高反射信号,视网膜前及视盘表面出血呈高反射信号,视网膜深层出血呈出血性或浆液性神经上皮脱离.结论 出血性埋藏性视盘玻璃疣患者出血可以位于视网膜前、视盘表面及视网膜深层等多个层次,SD-OCT联合眼底照相、FFA可以明确诊断.

abstractsObjective To investigate the clinical features of buried optic disc drusen with hemorrhage.Methods Retrospectively analyzed the data of 38 cases of buried optic disc drusen with epi-papillary hemorrhage,sub-retinal hemorrhage and/or pre-retinal hemorrhage (vitreous hemorrhage),all of which were diagnosed with fundus photography,fundus fluorescence angiography(FFA)and spectral-domain optical coherence tomography(SD-OCT),and thereafter the clinical characteristics of these cases were summarized.Results All patients had clinical symptoms,such as loss of visual acuity and shadows in front of the eyes.Of the 38 cases,38 subjects were noticed with epi-papillary hemorrhage and sub-retinal hemorrhage,and 8 with pre-retinal hemorrhage.Classic granular hyperfluorescence were seen in 23 cases at the late stage of FFA.On SD-OCT,buried optic disc drusen manifested itself as hyper-reflective nodular signal in the optic disc,pre-retinal hemorrhage and epi-papillary hemorrhage as hyper-reflective signals in front of retina and at the surface of papilla,and sub-retinal hemorrhage as hemorrhagic or serous neuroepithelial detachment.Conclusions All the buried optic disc drusens with hemorrhage were symptomatic,and the bleedings can locate at many layers,such as pre-retina,epi-papilla and sub-retina,which can be precisely diagnosed by SD-OCT in combination with fundus photography and FFA.