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1、眼底病、眼與全身病北京大學(xué)人民醫(yī)院眼科梁建宏醫(yī)學(xué)課件園www.yxkjy.comTheretinaThetermretinaderivesfromtheLatinwordrete,meaning"net.“Twofunctions:totransduceinformationfromanopticalimageintoelectricalsignalstoprocesscertainfeaturesofthevisualworldfromthephotoreceptorsignalsandrelaythisinformationtothebrainviatheopticner
2、ve醫(yī)學(xué)課件園www.yxkjy.com視網(wǎng)膜的組織學(xué)結(jié)構(gòu)及功能神經(jīng)上皮色素上皮---vitaminAmetabolismandregeneration---phagocytosisanddegradationofshedoutersegmenttips---lightabsorption---secretionofthematrixsurroundingthephotoreceptorinnerandoutersegments,---activetransportofmaterials醫(yī)學(xué)課件園www.yxkjy.com視網(wǎng)膜的血液供應(yīng)系統(tǒng)視網(wǎng)膜有獨(dú)特的雙重血液供應(yīng)系統(tǒng)：脈
3、絡(luò)膜血管---供應(yīng)外層視網(wǎng)膜視網(wǎng)膜血管---供應(yīng)內(nèi)層視網(wǎng)膜醫(yī)學(xué)課件園www.yxkjy.com血-視網(wǎng)膜屏障(Blood-retinalbarrier)InnerbarrierOuterbarrier醫(yī)學(xué)課件園www.yxkjy.com正常眼底圖醫(yī)學(xué)課件園www.yxkjy.com視網(wǎng)膜的病理視網(wǎng)膜異常血管視網(wǎng)膜出血視網(wǎng)膜水腫視網(wǎng)膜滲出視網(wǎng)膜神經(jīng)上皮與色素上皮分離視網(wǎng)膜新生物（腫瘤)視網(wǎng)膜先天發(fā)育異常醫(yī)學(xué)課件園www.yxkjy.com思考題視網(wǎng)膜的組織結(jié)構(gòu)，功能及血循環(huán)特點(diǎn)。臨床常見的視網(wǎng)膜病理改變。醫(yī)學(xué)課件園www.yxkjy.com視網(wǎng)膜血管病RetinalVascul
4、arDiseases視網(wǎng)膜靜脈阻塞視網(wǎng)膜動(dòng)脈阻塞視網(wǎng)膜血管瘤醫(yī)學(xué)課件園www.yxkjy.com視網(wǎng)膜靜脈阻塞Retinalveinocclusion,RVO病因：多因素致病。Thepreciseetiologyofretinalveinocclusionisnotentirelyclear.a）血管壁的改變b）血液流變性改變c）血流動(dòng)力學(xué)改變d）其他醫(yī)學(xué)課件園www.yxkjy.comRiskFactorsforRetinalVeinOcclusionIncreasedRiskSystemichypertensionDiabetesmellitusIncreasederyt
5、hrocytesedimentationrate(womenonly)HistoryofglaucomaDecreasedRiskIncreasinglevelsofphysicalactivityExogenousestrogens(womenonly)Increasinglevelsofalcoholconsumption(DatafromTheEyeDiseaseCase-ControlStudyGroup:Riskfactorsforcentralretinalveinocclusion.）醫(yī)學(xué)課件園www.yxkjy.com視網(wǎng)膜靜脈阻塞Retinalveinocc
6、lusion,RVO分類：視網(wǎng)膜中央靜脈阻塞centralretinalveinocclusion視網(wǎng)膜半側(cè)靜脈阻塞hemicentralretinalveinocclusion視網(wǎng)膜分支靜脈阻塞branchretinalveinocclusion分型：完全阻塞---缺血型ischemictype不完全阻塞---非缺血型nonischemictype醫(yī)學(xué)課件園www.yxkjy.com視網(wǎng)膜中央靜脈阻塞centralretinalveinocclusionAphysicalblockageatthelevelofthelaminacribrosa醫(yī)學(xué)課件園www.yxkjy.
7、com視網(wǎng)膜半側(cè)靜脈阻塞hemicentralretinalveinocclusion醫(yī)學(xué)課件園www.yxkjy.com視網(wǎng)膜分支靜脈阻塞branchretinalveinocclusion醫(yī)學(xué)課件園www.yxkjy.com臨床表現(xiàn)視力：無(wú)痛性下降眼底：視網(wǎng)膜出血視網(wǎng)膜水腫，黃斑水腫視網(wǎng)膜滲出靜脈迂曲、擴(kuò)張視網(wǎng)膜中央靜脈阻塞醫(yī)學(xué)課件園www.yxkjy.com視網(wǎng)膜中央靜脈阻塞缺血型ischemictype非缺血型nonischemictype醫(yī)學(xué)課件園www.yxkjy.com治療病因治療：控制血
