有效的视网膜微动脉牵拉是近视性黄斑劈裂可能的致病因素  

Potent retinal arteriolar traction as a possible cause of myopic foveoschisis

作　　者：Ikuno Y. Gomi F. Tano Y. 王永强 

机构地区：[1]Department of Ophthalmology, Osaka University Medical School, 2-2 Yamadaoka, Suita 565-0871, Japan Dr.

出　　处：《世界核心医学期刊文摘（眼科学分册）》2005年第8期22-23,共2页Digest of the World Core Medical Journals:Ophthalmology

摘　　要：PURPOSE: To report retinal microfold formation after vitrectomy for myopic fov eoschisis (MF). DESIGN: Prospective observational study. METHODS: We observed 21 eyes of 17 patients who had undergone vitrectomy for MF with optical coherence tomography (OCT) in this institutional study. We also evaluated the three-dimen sional retinal architecture using the OCT-ophthalmoscope in selected cases. Vit rectomy included core vitrectomy, vitreous cortex removal, internal limiting mem brane (ILM) peeling with indocyanine green, and gas tamponade. RESULTS: Horizont al linear folds were commonly observed postoperatively. The folds, which were 1, 000 to 2,000 μm superior, inferior, or both superior and inferior to the fovea, were detected only by OCT and not by conventional slit-lamp- based biomicroscopy. The microfolds were found in only five eyes (24%) 1 mont h postoperatively. The incidence increased over time, however, and a microfold w as detected in nine eyes (43%) 3 months after surgery and in 13 (62%) 6 months after surgery. OCT-ophthalmoscope examination confirmed the location of the mi crofold coincided exactly with that of retinal arteriole. The presence of microf olds was not significantly related to the postoperative visual acuity. CONCLUSIO NS: Retinal microfolds are common in eyes with MF after vitrectomy with ILM peel ing, and they seem to be generated as the result of insufficient flexibility of the sclerotic retinal arteriole during axial length elongation in highly myopic eyes. This finding suggests that the inward tractional force on the retina along the arteriole may be closely related to the pathogenesis of vitreoretinal disea ses specific to high myopia, including MF or paravascular microhole formation.PURPOSE: To report retinal microfold formation after vitrectomy for myopic fov eoschisis (MF). DESIGN: Prospective observational study. METHODS: We observed 21 eyes of 17 patients who had undergone vitrectomy for MF with optical coherence tomography (OCT) in this institutional study. We also evaluated the three-dimen sional retinal architecture using the OCT-ophthalmoscope in selected cases. Vit rectomy included core vitrectomy, vitreous cortex removal, internal limiting mem brane (ILM) peeling with indocyanine green, and gas tamponade. RESULTS: Horizont al linear folds were commonly observed postoperatively. The folds, which were 1, 000 to 2,000 μm superior, inferior, or both superior and inferior to the fovea, were detected only by OCT and not by conventional slit-lamp- based biomicroscopy. The microfolds were found in only five eyes (24%) 1 mont h postoperatively. The incidence increased over time, however, and a microfold w as detected in nine eyes (43%) 3 months after surgery and in 13 (62%) 6 months after surgery. OCT-ophthalmoscope examination confirmed the location of the mi crofold coincided exactly with that of retinal arteriole. The presence of microf olds was not significantly related to the postoperative visual acuity. CONCLUSIO NS: Retinal microfolds are common in eyes with MF after vitrectomy with ILM peel ing, and they seem to be generated as the result of insufficient flexibility of the sclerotic retinal arteriole during axial length elongation in highly myopic eyes. This finding suggests that the inward tractional force on the retina along the arteriole may be closely related to the pathogenesis of vitreoretinal disea ses specific to high myopia, including MF or paravascular microhole formation.

关 键 词：近视性 玻璃体切割 中心凹 微动脉 内界膜 眼轴长度 玻璃体疾病 高度近视眼 靛氰绿 显微镜检测 

分 类 号：R774.5[医药卫生—眼科]