国际眼科杂志2025，Vol.25Issue(7)：1084-1088,5.DOI:10.3980/j.issn.1672-5123.2025.7.08
远达性视网膜病变致病机制的研究进展
Progress in the pathogenic mechanism of Purtscher retinopathy
摘要
Abstract
Purtscher retinopathy is an occlusive retinal microangiopathy typically associated with trauma.It is characterized by a series of retinal pathological manifestations,such as cotton wool spots,multiple gray plaques(Purtscher spots)in the posterior pole,and intraretinal hemorrhage.Notably,there is no history of direct ocular trauma,as this condition is commonly observed in cases of severe crush injuries to the head,chest,abdomen,limbs,and other regions.Purtscher-like retinopathy,on the other hand,describes extensive retinopathy occurring in the absence of trauma,often associated with conditions such as pancreatitis and connective tissue diseases.With advancements in imaging-assisted ultrastructure research,the understanding of the pathogenesis of this retinopathy has evolved.Initially,it was attributed to trauma-induced injury and the subsequent cascade of damage repair processes.However,current theories suggest that systemic lesions involving lipase,free fatty acids,or complement activation play a significant role in inducing endothelial damage to small retinal blood vessels,ultimately leading to vascular occlusion.The pathogenesis of Purtscher retinopathy is not isolated;it is now widely believed to involve anterior capillary arteriole embolism resulting from changes in retinal microvascular permeability.In addition to embolization,other mechanisms such as retinal vascular-lymphatic extravasation,vasospasm,endothelial injury,and complement activation are also considered crucial contributors to the development of this condition.This paper starts from the inflammation and vascular cascade reaction in the pathological process of trauma and non-trauma,and expounds the pathological mechanism of the disease so as to guide the clinical diagnosis and treatment,in order to find new ideas of diagnosis and treatment in the research of rare diseases.关键词
远达性视网膜病变/微血管/栓塞/补体Key words
Purtscher retinopathy/microvascular/embolism/complement引用本文复制引用
陈敏,岳红云,杨冰玉..远达性视网膜病变致病机制的研究进展[J].国际眼科杂志,2025,25(7):1084-1088,5.基金项目
联勤保障部队第九四○医院院内基金项目(No.2021yxky032) Fund Project of the 940th Hospital of Joint Service Support Forces of the Chinese People's Liberation Army(No.2021yxky032) （No.2021yxky032）
