病理性近视引起视力下降的影像学病因分析  

Imaging etiology of pathological myopia results in visual impairment

作　　者：陈彦茹 黎晓新 李明翰 Chen Yanru;Li Xiaoxin;Li Minghan(Xiamen Eye Center of Xiamen University,Xiamen 361000,China)

机构地区：[1]厦门大学附属厦门眼科中心,361000

出　　处：《中华实验眼科杂志》2021年第6期528-533,共6页Chinese Journal Of Experimental Ophthalmology

摘　　要：目的分析病理性近视引起视力下降的影像学病因。方法采用横断面研究。分析2016年6月1日至2017年5月31日在厦门大学附属厦门眼科中心诊断为病理性近视合并视力下降110例138眼患者的临床资料,分别采用彩色眼底照相判断漆裂纹,频域光相干断层扫描(SD-OCT)、荧光素眼底血管造影、吲哚菁绿血管造影和光相干断层扫描血管成像(OCTA)评估脉络膜新生血管(CNV)和点状内层脉络膜病变(PIC),SD-OCT评估黄斑区视网膜劈裂(MRS)、黄斑萎缩、黄斑裂孔和黄斑前膜,并分析病理性近视合并视力下降的不同眼底病变比例和年龄分布。结果在病理性近视引起视力下降的影像学病因中,近视性CNV(MCNV)患者占63.0%(87/138),比例最高;其次为漆裂纹患者,占38.4%(53/138),MRS和黄斑萎缩分别占34.8%(48/138)和31.9%(44/138),黄斑前膜占30.4%(42/138),黄斑板层裂孔占10.1%(14/138),黄斑全层裂孔占13.8%(19/138),PIC占2.2%(3/138)。MCNV患者平均年龄(53.00±1.51)岁;漆裂纹患者平均年龄(53.00±1.77)岁;MRS、黄斑萎缩患者平均年龄分别为(58.00±1.64)岁和(57.00±1.76)岁;黄斑前膜患者平均年龄为(59.00±1.48)岁;黄斑板层孔、黄斑全层裂孔伴视网膜脱离(RD)和黄斑全层裂孔不伴RD患者平均年龄分别为(61.00±3.90)、(59.00±3.39)和(67.00±0.50)岁;PIC患者平均年龄为(31.00±8.50)岁,明显低于其他各组,差异均有统计学意义(均P<0.05)。结论病理性近视引起视力下降的主要原因是黄斑区结构的明显异常改变,以MCNV最常见。Objective To analyze the imaging etiology of patients having vision loss with pathological myopia.Methods A cross-sectional study was conducted.The clinical data of 110 cases(138 eyes)who had vision loss with pathological myopia diagnosed in Xiamen Eye Center of Xiamen University from June 1st,2016 to May 31st,2017 was collected and analyzed.Fundus photography was used to observe lacquer cracks;spectral domain optical coherence tomography(SD-OCT),fundus fluorescein angiography,indocyanine green angiography and optical coherence tomography angiography(OCTA)were employed to evaluate the choroidal neovascularization(CNV)and punctate inner choroidopathy(PIC).The macular retinoschisis(MRS),macular atrophy,macular hole and epiretinal membranes were assessed by SD-OCT.The proportion and age distribution of different fundus lesions of pathological myopia complicated with vision loss were analyzed.The study protocol was approved by an Ethics Committee of Xiamen Eye Center of Xiamen University(No.XMYKZX-2016-KY-010).Written informed consent was obtained from each patient before study.Results Among the imaging causes of visual impairment caused by pathological myopia,there were 87(63.0%)eyes of myopic CNV(MCNV)with the highest proportion,followed by 53(38.4%)eyes of lacquer cracks,48(34.8%)eyes of MRS,44(31.9%)eyes of macular atrophy,42(30.4%)eyes of epiretinal membranes,14(10.1%)eyes of macular lamellar hole,19(13.8%)eyes of full-thickness macular hole(FTMH),and 3(2.2%)eyes of PIC.The average age was(53.00±1.51)years of MCNV,(53.00±1.77)years of lacquer cracks,(58.00±1.64)years of MRS,(57.00±1.76)years of macular atrophy,(59.00±1.48)years of epiretinal membranes,(61.00±3.90)years of macular lamellar hole,(59.00±3.39)years of FTMH with retinal detachment(RD),and(67.00±0.50)years of FTMH without RD.The average age of PIC patients was(31.00±8.50)years,which was significantly smaller than that of the other groups(all at P<0.05).Conclusions The main cause of visual impairment resulted from pathological myopia is the ob

关 键 词：脉络膜新生血管 病理性近视 病因 影像学 

分 类 号：R778.11[医药卫生—眼科]