高度近视眼底及后极部的影像学评估  

Iconography evaluation of fundus and posterior pole in high myopia

作　　者：庞雪娜 杨鸽[1] 万文萃[1] 刘宇莹[1] 杨果果 金学民[1] 

机构地区：[1]郑州大学第一附属医院眼科郑州大学眼底病研究所,河南省郑州市450000

出　　处：《眼科新进展》2016年第5期461-465,共5页Recent Advances in Ophthalmology

摘　　要：目的观察高度近视眼底及后极部在眼底彩照、光学相干断层成像(optical coherence tomography,OCT)、眼部B超及3D-MRI检查中的图像特征,分析各种检查在高度近视不同进展阶段的评估价值。方法对32例(60眼)高度近视患者,根据屈光度大小分为A、B两组,A组屈光度为-6.00^-10.00 D,B组屈光度为-10.25^-26.00 D,测量眼轴长度后,分别行眼底彩照、OCT、眼部B超及3D-MRI检查,比较两组病例在各项检查中的表现。结果 A组眼轴长度为(26.52±1.70)mm,眼底彩照73.08%表现为豹纹状眼底+视盘弧形斑,此时OCT、B超、3D-MRI未显示特殊改变;B组眼轴长度为(28.80±2.24)mm,眼底彩照88.24%出现较豹纹状眼底+视盘弧形斑更严重的表现,OCT表现出各种特征性改变,B超可以显示后巩膜葡萄肿分级,3D-MRI表现出眼球的各种形态改变。结论高度近视患者屈光度数≤-10.00 D时眼底及后极部改变相对较轻,屈光度>-10.00 D时眼底及后极部改变相对较重;眼底彩照可早期显示高度近视的眼底改变,随病变进展,与OCT、B超、3D-MRI的综合评估有助于全面了解病变的发展阶段和严重程度。Objective To observe the image characteristics of color fundus photography,optical coherence tom ography（ O C T）,ocular ultrasound and three-dim ensional m agnetic resolution im aging（ 3 D-MR I） of fundus and posterior pole in high m yopia,and respectively discuss the clinical application value in different developm ent stage. Meth o d s Thirty-tw o high m yopia patients（ 6 0 eyes） w ere divided into group A and B according to the size of diopter,w hich in group A w as from- 6. 0 0 D to-1 0. 0 0 D,group B w as from- 1 0. 2 5 D to- 2 6. 0 0 D,after m easuring the ocular axial length,the exam inations of color fundus photography,O C T,B ultrasound and3 D-MR I,then the perform ances of the exam inations w ere com pared betw een tw o groups. R esu lts In group A,the ocular axis length w as（ 2 6. 5 2 ± 1. 7 0） m m,7 3.0 8 % of eyes show ed the tessellated fundus ＋ com us in color fundus photography,but O C T,B ultrasound and 3 D-MR I show ed no special change. In group B,the ocular axis length w as（ 2 8. 8 0 ± 2. 2 4） m m,8 8. 2 4 % of eyes show ed m ore serious perform-ances than tessellated fundus ＋ com us,O C T show ed various characteristic changes,B ultrasound exhibited the grade of scleral staphyloma,3D-MRI showed various forms of changes.Conclusion High myopia patients with diopter ≤- 10. 00 D show relatively light lesion,with diopter - 10. 00 D show relatively heavy lesion. Color fundus photography can display early changes of high myopia,along with the lesions progress,the comprehensive evaluation together with OCT,B ultrasound and 3D-MRI is conducive to a comprehensive understanding of disease stages and severity.

关 键 词：高度近视 后巩膜葡萄肿 眼底彩照 光学相干断层成像 眼部B超 3D-MRI 

分 类 号：R657.3[医药卫生—外科学]