病理性近视眼底病变的光相干断层扫描病理形态学改变  

The Image Futures of Optical Coherence Tomography of the Pathological Changes in Degenerative Myopia

作　　者：时乐[1] 黎蕾[1] 姜春辉[1] 王玲[1] 黄欣[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科,上海200031

出　　处：《中国临床医学》2006年第2期305-306,329,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:观察病理性近视眼底病变的光相干断层扫描(OCT)病理形态学改变特征。方法:临床检查确诊为病理性近视患者100例(172眼)行OCT检查。用Macular Thickness Map、Fast Macular Thickness及Line程序扫描黄斑区、视乳头、颞侧大血管弓、色素改变及近视弧等部位。结果:将病理性近视眼底病变按部位不同分为4类,其中,玻璃体视网膜界面病变中89眼(51．7％)可见玻璃体后皮质黏附,黄斑全层裂孔15眼(8．7％),黄斑板层孔2眼(1．2％)．黄斑前膜(EMR) 11眼(6．4％)。视网膜神经上皮层改变中13眼(7．6％)发生无黄斑裂孔的后极部神经上皮层浅脱离,其中5眼(2．9％)可见后极部视网膜脱离周边部网膜外层劈裂,神经上皮层内层劈裂3眼(1．2％)。33眼(20％)发生视乳头颞侧近视弧处视网膜神经上皮层浅脱离。色素上皮及脉络膜病变中140眼(81．4％)视网膜色素上皮不均匀萎缩,Fuchs斑10眼(5．7％), 近视弧165眼(95．9％),后极部脉络膜广泛萎缩117(68．0％)眼。黄斑区脉络膜新生血管25眼(14．5％)。巩膜改变中后巩膜葡萄肿146眼(84．9％)。结论:OCT可活体观察病理性近视的眼底组织病理学改变,对分析其眼底病变特征及病程观察有重要价值。Objective： To observe the pathological changes of degenerative myopia by optical coherence tomography（OCT）. Methods： The OCT data of 100 patients （172 eyes）wlth degenerative myopia were retrospectively analyzed. The scan models of included macular thickness map,fast macular thickness and line. Scans were undertaken at the regions of macular, optic papilla,posterior pole of retina , temporal larger retinal vessels , temporal crescent and pigment distribution abnormality. Results： Four categories were divided according to different parts where pathologic changes developed. At vitreoretinal interface, we found posterior vitreous hyaloid inserting to the retinal surface in 89 eyes （51.7%） ,full-thickness rnacular hole in 15 eyes （8.7 % ）, lamellar macular hole in 2 eyes （ 1.2 % ）, epiretinal memberane （ERM） in 11 eyes （ 6.4 % ）. In retina layer , post erior shallow retinal detachment were found in 13 eyes （7. 6%）,of which 5 eyes（2.9%） associated with outer retinal schisis and 2 eyes（1.2%） associated with inner retinal schisis. In RPE and choroidal layer , we found RPE atrophy in 140 eyes（81.4%）, Fuchs spots in 10 eyes（5.7%）, temporal crescent in 165 eyes （95. 9%） ,choroidal atrophy in 117 eyes（68.0%）and macular choroidal neovascularization in 25 eyes（14. 5%）. In sclera layer, posterior staphylomas were observed in 146 eyes （84. 9%）. Conclusion ：OCT can display the pathological changes of retinal tissues of degenerative myopia in vivo.

关 键 词：视网膜疾病 光学相干断层扫描 病理性近视 

分 类 号：R774[医药卫生—眼科]