黄斑区光感受器内外节层局部微小缺失初步分析  

Preliminary analysis of the photoreceptor inner/outer segment （IS/OS） layer local deletion in macular

作　　者：杨丽亚[1] 韩梅[1] 解士勇[1] 杨凯转[1] 徐延山[1] 

机构地区：[1]天津医科大学眼科临床学院天津市眼科医院,天津市300020

出　　处：《中国实用眼科杂志》2013年第3期267-269,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的了解黄斑区光感受器内外节（IS／OS）层局部微小缺失的常见病因及相干光断层扫描（OCT）特征。方法临床病例回顾性研究。回顾性分析2009年6月到2012年1月在天津市眼科医院门诊患者资料，OCT示患眼黄斑区IS／OS层局部微小缺失、中断，视网膜缺失区域外不伴有其他形态学改变，从患者的病历资料中提取病史及最佳矫正视力（BCVA）、眼底彩色照相、OCT、FFA等检查结果。结果90例98只眼。视力均有不同程度下降、视物模糊或伴眼前黑影。原因未明者47例47只眼（48．0％），外伤史者17例18只眼（18．4％），黄斑裂孔术后者7例7只眼（7．1％），眼底出血吸收后者5例5眼（5．1％），电焊伤者4例8眼（8．2％），激光损伤者3例4眼（4．1％），电击伤者2例3只眼（3．1％），高度近视者2例2只眼（2．0％），中心性浆液性脉络膜视网膜病变（中浆）恢复后者1例1只眼（1．0％），合并青光眼者1例2只眼（2．0％3，合并糖尿病者1例1只眼（1．0％）。眼底彩色照相显示黄斑区m现圆形或椭圆形、边界不清的暗黄色改变者72例80只眼（81．6％），未发现明显改变者18例18只眼（18．4％）。OCT示黄斑区均可见IS／OS层局部缺失、中断，视网膜缺失区域外不伴有其他形态学改变：37例行荧光素眼底血管造影（FFA）检查，未见明显异常。结论多种因素均可导致黄斑区IS／OS层部分缺失，致病因素目前尚未完全明确；视功能均有不同程度损害；OCT检查能够明确病变部位，对临床诊疗具有指导意义。ObJective To study the common etiology and optical coherence tomography （OCT） characteristics of the photoreceptor inner/outer segment （IS/OS） layer local deletion in macular. Methods The clinical data of outpatients from June 2009 to January 2012 in Tianjin Eye Hospital were summarized and analyzed retrospectively, and their OCT examination revealed that the IS/OS layer local deletion and break in macular was not associated with other morphological changes out- side the region of retina missing. The history, vision, fundus photography and OCT examination resuits were extracted from the patient＇s medical records. Results Ninety-eight eyes of 90 cases showed that visual acuity decreased with blurred vision or immediate shadow. Forty-seven eyes of 47 cases （48.0%） had no clear etiological factors; 18 eyes of 17 cases （18.4%） associated with other types of traumatic retinopathy; 7 eyes of 7 cases （7.1%） had macular hole surgery before; 5 eyes of 5 cases （5.1%） had subhyaloid hemorrhage; 4 cases （8.2%） were welders, both eyes injurins; 4 eyes of 3 cases （4.1%） were laser injuries; 3 eyes of 2 cases （3.1%） had recent electrical injuries; 2 eyes of 2 cases （2.0%） were high myopia; 1 eye of 1 case （1.0%） restored from central serous cho- rioretinopathy; 2 eyes of 1 case （1.0%） were with glaucoma and 1 eye of 1 case was with diabetes.Fundus photography showed that 80 eyes of 72 cases could be found round or oval, ill-defined dark yellow changes in macular and the others were without significant changes. All the eyes＇ OCT exam- ination revealed that the IS/OS layer local deletion and break in macular was not associated with other morphological changes outside the region of retina missing. Conclusions The causes of IS/ OS layer local deletion and break in macular are very complicate, and many of them are indefinite. The location can impair visual function more or less. It is possible to use OCT to precisely locate diseased regions, thus providing guidance to the clinical

关 键 词：光感受器内外节层 缺失 病因 相干光断层扫描 

分 类 号：R698.202[医药卫生—泌尿科学]