目的 探讨高度近视眼黄斑病变的眼底形态学改变和光学相干断层扫描的特征。
方法 回顾性分析2010年3月以来在我院就诊的66例88只眼诊断为病理性近视的患者黄斑部病变的眼底和表现特点。男性27例,女性39例,年龄17-71岁,平均年龄45岁,屈光度-6D—--21D,平均屈光度-12D,
结果 88眼中眼底表现为黄斑区视网膜劈裂26眼,占26%,OCT显示89%为外层视网膜劈裂,其余显示为内层视网膜劈裂,黄斑萎缩21眼,占24%,OCT表现为视网膜神经上皮层变薄,色素上皮层萎缩或不连续。黄斑区视网膜浅脱离5只眼,占5.1%,OCT表现为黄斑区神经上皮层局限性隆起。黄斑裂孔8眼,OCT显示为全层裂孔6只眼,占6.1%,板层裂孔2只眼,占2.6%。黄斑区出血,新生血管膜5只眼,占6.2%,OCT显示为黄斑区神经上皮下的团状高反射信号。视网膜前膜7只眼,占8.6%,OCT显示为视网膜表面高反光带。黄斑水肿5只眼,占5.1%,OCT显示为视网膜神经上皮层水肿。
结论 高度近视眼黄斑病变发病率高,可合并多种多样的眼底改变,包括黄斑劈裂、黄斑萎缩、黄斑浅脱离、黄斑前膜、黄斑裂孔等。光学相干断层扫描是高度近视黄斑部病变的有效辅助检查手段,可以清晰地显示黄斑的微细结构变化,具有不可替代性。
Objective To dicuss the characteristics of fundus manifestation and optical coherence tomography ﹝OCT﹞ result in pathologic myopic maculopathy.
Methods Retrospectively the characteristics of fundus manifestation and OCT result of 66 cases 88 eye dignosed pathologic myopic who visit opthalmology department of PUMCH during 2010 were analyzed.
Results Of the 88 eyes, fundus showed macular retinoschisis in 26 eyes 26% ,OCT revealed 89% were inner-layer retinoschisis . Macular atrophy was found in 21 eyes 24% ,OCT showed thinner neuro-retina and atrophic or discontinuous RPE . Retinal detachment. Was found in 5 eyes 5.1% , OCT showed localized retinal detachment . Macular hole was found in 8 eyes, OCT revealed full-thickness macular hole in 6 eyes 6.1% ; lamellar macular hole en 2 eyes 2.6%. Macular hemorrhage, neovascularization was found in 5 eyes 6.2%. OCT showed macular chouoidal neovascularezation. Epiretinal membrane was found in 7 eyes 8.6%, OCT showed high reflective tissue . Macular edema was found en 5 eyes 5.1% , OCT showed intra-retinal edema.
Conclusions Pathologic myopic maculopathy has a high incidence and has varied clinical manifestation. OCT is quite usuful in identijying them. . |