儿童黄斑部视网膜内界膜下积血玻璃体切割疗效分析  

Vitrectomy with macular sub-inner limiting membrane hemorrhage in children

作　　者：石芊[1] 彭秀军[1] 王桂琴[1] 卢成戎[1] 

机构地区：[1]海军总医院眼科,北京市100048

出　　处：《中国实用眼科杂志》2014年第11期1364-1366,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的 探讨儿童黄斑部视网膜内界膜下积血特点及玻璃体切割手术治疗的临床疗效.方法 对2012年9月至2013年6月在海军总医院眼科治疗的5例（8只眼）儿童黄斑部视网膜内界膜下积血行玻璃体切割手术治疗的患者进行回顾性分析,总结儿童黄斑部视网膜内界膜下积血特点及行玻璃体切割手术临床疗效.结果 儿童视网膜内界膜下出血常见于间接性眼外伤及血液病,一般发现较晚,或因全身情况及专科就诊较晚,积血分解产物进入玻璃体引起玻璃体变性呈黄白色混浊,积血表面内界膜增厚机化引起血管弓部环形视网膜嵴,甚至牵拉性脱离,含铁血黄素对视网膜毒性作用明显.行玻璃体切割手术治疗,1只眼术中发现视网膜撕裂口,视网膜脱离僵硬明显,术中放弃进一步治疗.另7只眼行常规23 G玻璃体切割手术.术后随诊3～6个月,最佳矫正视力2只眼0.8,0.15、0.3和0.4各1只眼,另2只眼患儿视力检查不配合,但交替遮盖时均能主动寻找玩具.术后无明显并发症.结论 儿童黄斑部视网膜内界膜下出血具有相对特殊的临床特点,及时发现并行微创玻璃体切割手术可取得较好地疗效.Objective To observe the clinical characteristics and the efficacy of vitrectomy on macular sub-inner limiting membrane hemorrhage in children.Methods A retrospective analysis on 5 child patients （8 eyes） with macular sub-inner limiting membrane hemorrhage who were admitted to our hospital from September 2012 to June 2013.The clinical characteristics and the efficacy of vitrectomy were explored.Results Macular sub-inner limiting membrane hemorrhage in children was frequently found in indirect eye traumas and blood diseases.Generally,patients were sent to visit ocular trauma lately due to firstly treat systemic disorder and traumas of main organ.The macular inner limiting membrane on blood became thickness and proliferation which caused retinal cristae around arcade and retinal detachment.The toxicity of hemosiderin to retina and vitreous was apparent.For one eye,surgery was discontinued because the detachment of the retina generated tearing hole and stiffness.Seven eyes were undergone 23G vitrectomy.Follow-up time was 3 to 6 months after surgery,the best corrected visual acuity separately were 0.8 （two eyes）,0.15 （one eye）,0.3（one eye） 0.4 （one eye）.For one child whose visual acuity could not be checked accurately,but visual function in the both eyes also obviously improved.There were no serious complications during surgical procedure.Conclusions For diagnosis and treatment,there are the clinical characteristics and divergence in macular sub-inner limiting membrane hemorrhage in children.Vitrectomy is an effective treatment method.

关 键 词：黄斑部视网膜内界膜下出血 儿童 玻璃体切割术 

分 类 号：R779.6[医药卫生—眼科]