Peripheral Retinal Vascular Patterns in Patients with Rhegmatogenous Retinal Detachment in Taiwan

This is an observational study of fluorescein angiography (FA) in consecutive patients with rhegmatogenous retinal detachment (RRD) in Changhua Christian Hospital to investigate the peripheral retinal vascular patterns in those patients. All patients had their age, sex, axial length (AXL), and refraction status (RF) recorded. According to the findings in FA of the peripheral retina, the eyes were divided into 4 groups: in group 1, there was a ramified pattern of peripheral retinal vasculature with gradual tapering; in group 2, there was an abrupt ending of peripheral vasculature with peripheral non-perfusion; in group 3, there was a curving route of peripheral vasculature forming vascular arcades or anastomosis; and in group 4, the same as in group 3, but with one or more wedge-shaped avascular notches. Comparisons of age, sex, AXL, and RF, association of breaks with lattice degeneration and retinal non-perfusion, surgical procedures utilized, and mean numbers of operations were made among the four groups. Of the 73 eyes studied, there were 13 eyes (17.8%) in group 1, 3 eyes (4.1%) in group 2, 40 eyes (54.8%) in group 3 and 17 eyes (23.3%) in group 4. Significant differences in age, AXL and RF, and association of retinal breaks to non-perfusion were noted among the four groups. Patients in group 1 had older ages, while younger ages were noted in groups 3 and 4. Eyes in group 1 had the shortest average AXL and were least myopic in contrast to the eyes in groups 3 and 4. Association of retinal breaks and retinal non-perfusion was significantly higher in groups 2, 3 and 4 than in group 1. In conclusion, peripheral vascular anomalies are common in cases with RRD. Patients with peripheral non-perfusion tend to be younger, with longer axial length and have the breaks associated with retinal non-perfusion.本研究为一项观察性研究，针对彰化基督教医院连续收治的孔源性视网膜脱离（rhegmatogenous retinal detachment, RRD）患者实施荧光素眼底血管造影（fluorescein angiography, FA）检查，旨在探究此类患者的周边视网膜血管形态特征。所有患者均记录了年龄、性别、眼轴长度（axial length, AXL）与屈光状态（refraction status, RF）。依据周边视网膜荧光素眼底血管造影结果，将患眼划分为4组：第1组周边视网膜血管呈分支状且逐渐变细；第2组周边血管骤然终止，伴周边视网膜无灌注；第3组周边血管走行弯曲，形成血管弓或吻合支；第4组表现与第3组相似，但存在一处或多处楔形无灌注切迹。研究团队对4组患者的年龄、性别、眼轴长度、屈光状态，视网膜裂孔与格子样变性、视网膜无灌注的相关性，所采用的手术方式及平均手术次数开展了对比分析。本研究共纳入73只患眼，其中第1组13只（17.8%），第2组3只（4.1%），第3组40只（54.8%），第4组17只（23.3%）。4组患者在年龄、眼轴长度、屈光状态，以及视网膜裂孔与无灌注的相关性方面存在显著差异。第1组患者年龄偏高，而第3、4组患者年龄偏低。第1组患眼的平均眼轴长度最短，近视程度最轻，与第3、4组患眼差异显著。第2、3、4组中视网膜裂孔与视网膜无灌注的关联比例显著高于第1组。综上，周边血管异常在孔源性视网膜脱离患者中较为常见。伴周边视网膜无灌注的患者通常更年轻，眼轴更长，且其视网膜裂孔多与视网膜无灌注相关联。