黄斑光损伤病因分析及临床特点  

The cause analysis and clinical characteristics of macular light damage

作　　者：王婧[1] 李秋明[1] 董洪涛[1] 

机构地区：[1]郑州大学第一附属医院眼科,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2017年第5期338-341,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨黄斑光损伤的病因及临床特点。方法回顾分析2009年1月至2014年12月黄斑光损伤25例（34眼）的临床资料，对前3年与后3年的患者资料进行对比，并分析频域OCT、眼底照相及荧光素眼底血管造影所观察的黄斑光损伤的临床特点。结果前3年（2009年至2011年），黄斑光损伤11例，男女比例为4．5：1（9／2）。而后3年（2012年至2014年），黄斑光损伤14例，男女比例为2．5：1（10／4）。病因是电焊损伤最多（电弧光）共有10例（14眼，41．18％）；其次是Et蚀伤和Et光或高原紫外线引起的黄斑光损伤7例（12眼，35．29％）；再次是电脑或长时间看手机的发光二极管显示屏引起的光损伤5例（5眼，14．71％）。所有患眼的黄斑均具有明显的临床改变。但频域OCT显示黄斑视锥细胞内外节膜盘及部分视网膜色素细胞层的高反射信号的异常甚至于信号的断裂，部分伴有视网膜层间的低反射暗腔。结论后3年更多的女性发生黄斑光损伤。频域OCT是帮助诊断黄斑光损伤的既快且优的技术，能显示患眼的显著形态学改变。Objective To explore the the etiology and clinical characteristics of macular light damage. Methods The clinical data of 34 eyes of 25 cases with macular light damage from Jan. 2009 to Dec. 2014 were collected and retrospectively analyzed. The data of first 3 years and the last 3 years were eomparied. The frequency domain optical coherence tomography, fundus photography and fluorescein fundus angiography were used to observe and analyze the clinical characteistics of macular light damage. Results The first 3 years, from 2009 to 2011, 11 cases of macular light damage, sex ratio was 4.5：1 （9/2）. The last 3 years, from 2012 to 2014 ,macular light damage in 14 cases, the male to female ratio was 2.5 ： 1 （10/4）. The main cause was welding damage（electric arc） in 14 eyes（41.18% ） of 10 cases. The second cause was the solar eclipse injury and ultraviolet of sunlight on plateau in 12 eyes of 7 cases （35.29%）. The light damage of computer and mobile phone of the light-emitting diode in 5 eyes of 5 cases （ 14.71% ）. In all cases , the macula had obvious clinical changes. Frequency domain optical coherence tomography showed that the high reflection signals of macula cones inside and outside layer plate and part of the retinal pigment cells layer were abnormal and even fracture, some accompanied by retinal layers low reflective dark cavity. Conclusion The last 3 years, more women occurr maeular light injuries. Frequency domain optical coherence tomography is helpful for the diagnosis of macular light damage. It is a fast and optimal technology, can show significant morphologic changes.

关 键 词：黄斑 光损伤 光学相干断层扫描 频域 

分 类 号：R774.5[医药卫生—眼科]