目的：探讨鼻咽癌放疗术后眼部并发症的临床特点、荧光素及吲哚菁绿血管造影特征、影响因素及其诊治方法。

方法：回顾性分析2007-03/2012-03我院眼科收治的因鼻咽癌放疗后视力下降的患者33例63眼的临床资料。

结果：所有患者均以进行性、无痛性单眼或双眼视力下降为主要临床表现。放射性视网膜病变48眼，其中视网膜中央动脉阻塞2眼，视网膜中央静脉阻塞3眼，色素上皮改变2眼，黄斑前膜1眼，其余40眼均出现后极部棉絮斑及出血。放射性视神经病变36眼，其中视神经边界清晰27眼，视神经边界不清9眼。黄斑区典型性脉络膜新生血管2眼，脉络膜转移灶1眼，脉络膜循环异常4眼，前部葡萄膜炎2眼，玻璃体积血7眼。

结论：鼻咽癌放疗术后眼部并发症复杂多样，最常见放射性视网膜病变和放射性视神经病变，少数表现为黄斑部脉络膜新生血管、动静脉阻塞、脉络膜循环异常等。

AIM: To investigate the clinical features, characteristics of fundus fluorescein angiography(FFA)indocyanine green angiography(ICGA), risk factors, diagnostic methods and therapies of ocular complications subsequent to radiotherapy of nasopharyngeal carcinoma(NPC).

METHODS: Thirty-three patients(63 eyes)with hypopsia subsequent to radiotherapy of NPC admitted to Chenzhou No. 1 People's Hospital from March 2007 to March 2012 were investigated retrospectively.

RESULTS: All cases manifested as progressive, painless hypopsia in binocular or monocular. Fifty-six eyes received FFA and ICGA. Forty-eight eyes showed radiation retinopathy, including 2 eyes with central retinal artery occlusion, 3 eyes with central retinal vein occlusion, 2 eyes with retinal pigment epithelial changes, 1 eye with epiretinal membrane and the remaining 40 eyes appeared cotton woolspots at posterior pole and hemorrhage. Thirty-six eyes manifested as radiation optic neuropathy, of them, optic border of 27 was clear, and that of 9 eyes was unclear. Two eyes were typical macular choroidal neovascularization(CNV), 1 eye was choroidal metastasis, 4 eyes presented choroidal abnormal circulation, 2 eyes displayed anterior uveitis and 7 eyes manifested vitreous hemorrage.

CONCLUSION:Ocular complications subsequent to radiotherapy of NPC are complicated and diverse, the most common damage is radiation retinopathy and radiation optic neuropathy, whereas the small number of them are characterized by macular CNV, arterio-venous obstruction and abnormal choroid.

郴州市第一人民医院院内课题资助(No.N2014-009)