高度近视黄斑裂孔性视网膜脱离合并脉络膜脱离的相关因素分析  

Analysis of the relative factors for rhegmatogenous retinal detachmort associated with choroidal de- tachment with macular hole in high myopia

作　　者：戎芳[1] 刘武[2] 

机构地区：[1]北京市普仁医院眼科,北京100062 [2]首都医科大学附属同仁医院眼科

出　　处：《中国实用眼科杂志》2009年第4期366-369,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨高度近视黄斑裂孔性视网膜脱离合并脉络膜脱离的相关危险因素，总结其临床特点及治疗方法。方法连续收集合并脉络膜脱离的高度近视黄斑裂孔性视网膜脱离的病例10例（A组），并以同一时期不伴脉络膜脱离的高度近视黄斑裂孔性视网膜脱离病例12例为对照（B组），对比两组发病年龄、病程、术前屈光度、眼轴、眼压、视网膜脱离范围以及术后视网膜复位、视功能恢复等情况。结果A组发病年龄大、近视度数高、眼压低、视网膜脱离范围大，与B组相比差异有统计学意义（P〈0．05），其中眼压差异显著（P〈0．01）；两组的一次玻璃体切割手术视网膜复位率相近，A组为80％，B组为83％，但A组术后视力≥0．02的比例低（P=0．048）。结论高度近视黄斑裂孔性视网膜脱离一旦合并脉络膜脱离常伴有年龄大、病程长、近视度数高、视网膜脱离广泛和显著低眼压等特点。适时采用玻璃体切割合并硅油填充术可达到与不合并脉络膜脱离组相近的视网膜复位率，但视力预后仍较差。Objective To evaluate the risk factors and therapy for rhegmatogenous retinal detachment （RRD）associated with choroidal detachment（ ChD ）with macular hole in high myopia.Method 10 consecutive eyes （group A）with rhegrnatogenous retinal detachment associated with choroidal detachment with macular hole in high myopia were reviewed, and 12 similar eyes（ group 13 ）without choroidal detachment in the same period were enrolled as controls.Age of onset, course of disease, degree of myopia, inlraocular pressure, extent of RD, retinal reattachment status and visual acuity were compared in all patients.Rusults In group A, the average age of onset is older, the degree of myopia is higher, the intraocular pressure is lower, and RD is more extensive compared with group 13 （P 〈0.05 ）.The proportions of retinal reattachment after first pars plana vitrectomy with silicon oil were similar：the percentage in group A is 80%, in group B is 83% .But the proportion of visual acuity after surgery better man 0.02 in group A is lower than that of group B（P =0.048 ）.Conclusion RRD -ChD with macular hole in high myopia is often seen in old patients with seriously high myopia, low intraocular pressure and extensive retinal detachment.Although retinal reattachment status after first pars plana vitrectomy with silicon oil are similar, the visual acuity after surgery is lower in patients associated with ChD compared with patients without ChD.

关 键 词：黄斑裂孔 视网膜脱离 脉络膜脱离 高度近视 

分 类 号：R774.12[医药卫生—眼科] R773.4[医药卫生—临床医学]