视网膜静脉阻塞相关危险因素的研究进展

Research Advances in Risk Factors Associated with Retinal Vein Occlusion

摘要: 视网膜静脉阻塞是导致视力下降的常见视网膜血管性疾病，其发病机制复杂，多种因素共同作用导致。本综述系统梳理了视网膜静脉阻塞相关的关键危险因素，研究表明在全身性血管因素中，高血压是最为确切的独立危险因素，糖尿病与高脂血症则通过加速动脉粥样硬化与内皮损伤参与致病；凝血异常因素中，以抗磷脂抗体综合征为代表的血栓前状态，通过诱发高凝状态显著增加视网膜静脉阻塞风险；在局部眼部因素中，短眼轴所致的筛板区拥挤及青光眼相关的视网膜微循环改变，共同构成静脉受压的解剖学基础。本文通过整合现有证据，旨在为视网膜静脉阻塞的个体化风险评估与一级预防策略提供理论依据，并指出未来研究应聚焦于多因素交互作用机制并为临床开展个体化防治制定了重要参考。

Abstract: Retinal vein occlusion (RVO) represents a common retinal vascular disorder that frequently leads to visual impairment, with its pathogenesis being multifactorial and complex. This review systematically delineates the key risk factors associated with RVO. Evidence demonstrates that among systemic vascular factors, hypertension stands as the most well-established independent risk factor, while diabetes mellitus and hyperlipidemia contribute to the pathogenesis through accelerated atherosclerosis and endothelial dysfunction. In the category of coagulation abnormalities, thrombophilic states, particularly antiphospholipid syndrome, significantly increase RVO risk by inducing hypercoagulability. Regarding local ocular factors, crowding at the lamina cribrosa resulting from short axial length, combined with glaucoma-associated alterations in retinal microcirculation, collectively constitute the anatomical basis for venous compression. By synthesizing current evidence, this review aims to provide a theoretical foundation for individualized risk assessment and primary prevention strategies for RVO, while proposing that future research should focus on elucidating the mechanisms underlying multifactorial interactions, thereby establishing critical references for developing personalized clinical management approaches.