病理性近视性血管旁异常和黄斑劈裂的影像学特征及其与临床特征的相关性  

Imaging features of pathological myopic perivascular abnormalities and macular retinoschisis and their correlation with clinical features

作　　者：安广琪 张敏[1,2] 刘培[1] 路晨雨 高文娜 金学民 杜利平[1] An Guangqi;Zhang Min;Liu Pei;Lu Chenyu;Gao Wenna;Jin Xuemin;Du Liping(Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Ophthalmology,Zhengzhou People's Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院眼科,郑州450052 [2]郑州人民医院眼科,郑州450000

出　　处：《中华眼底病杂志》2025年第2期98-105,共8页Chinese Journal of Ocular Fundus Diseases

基　　金：国家自然科学基金(82171040、82301271)。

摘　　要：目的观察并分析病理性近视性血管旁异常(PVA)和黄斑劈裂(MRS)的影像学特征及其与临床特征的关系。方法回顾性病例系列研究。2021年9月至2023年12月于郑州大学第一附属医院眼科检查确诊的病理性近视伴PVA和(或)MRS患者224例371只眼纳入研究。其中,男性48例74只眼,女性176例297只眼;年龄54(49,61)岁;等效球镜度(SE)−13.375(−18.00,−10.00)D;眼轴长度(AL)29.84(28.27,31.24)mm。根据超广角扫频源光相干断层图像特征,将PVA形态分为血管和血管旁微皱襞、血管旁视网膜囊肿、血管旁视网膜劈裂、血管旁板层黄斑裂孔;根据劈裂层次将MRS分为内层、外层、混合MRS,并据此分组。记录是否存在圆顶状黄斑(DSM)、内外板层黄斑裂孔及全层黄斑裂孔(FTMH)等合并症。依据PVA是否合并MRS,将患眼分为单纯PVA组、PVA合并MRS组;依据MRS是否累及中心小凹,将患眼分为MRS未累及中心小凹组、累及中心小凹组。不同组别患者年龄、SE、AL比较采用Mann-Whitney U检验;定性资料比较采用χ^(2)检验。结果371只眼中,单纯PVA组120只眼;MRS 251只眼,其中PVA合并MRS组208只眼。内板层、外板层黄斑裂孔以及FTMH伴或不伴视网膜脱离、脉络膜新生血管、DSM、视网膜前膜、单纯神经上皮层浅脱离分别为33、27、3、14、12、56、28、7只眼。PVA 328只眼中,血管和血管旁微皱襞、血管旁视网膜囊肿、血管旁视网膜劈裂、血管旁板层黄斑裂孔分别为151、236、202、72只眼。其中,单一病变者142只眼(43.29%,142/328);2种及以上病变者186只眼(56.71%,186/328)。MRS 251只眼中,内层MRS组、外层MRS组、混合MRS组分别为34、92、125只眼。累及中心小凹组155只眼;未累及中心小凹组96只眼。外层MRS组与内层MRS组和混合MRS组合并PVA眼数比较,差异均有统计学意义(χ^(2)=30.614、28.379,P<0.001)。与单纯PVA组比较,PVA合并MRS组更容易合并2种及以上PVA病变,差异有统计学�Objective To observe and analyze the imaging features of pathologic myopic paravascular abnormalities(PVA)and macular retinoschisis(MRS)and their relationship with clinical features.Methods A retrospective case series study.A total of 371 eyes of 224 patients with pathological myopia with PVA and/or MRS diagnosed by examination in Department of Ophthalmology of the First Affiliated Hospital of Zhengzhou University from September 2021 to December 2023 were included in the study.There were 74 eyes in 48 males and 297 eyes in 176 females.Age were 54(49,61)years;equivalent spherical lens(SE)was−13.375(−18.00,−10.00)D.Axial length(AL)was 29.84(28.27,31.24)mm.According to the features of ultra-wide-angle sweep source optical coherence tomography,PVA morphology was divided into blood vessels and paravascular microfolds,paravascular retinal cysts,paravascular retinal splits and paravascular lamellar macular holes.MRS was divided into inner layer,outer layer and mixed layer according to splitting level,and grouped accordingly.The presence of dome-shaped macula(DSM),internal and external lamellar macular hole,and full lamellar macular hole(FTMH)were recorded.According to whether PVA combined with MRS or not,the affected eyes were divided into PVA group and PVA combined with MRS group.According to whether MRS involved the fovea,the affected eyes were divided into two groups:MRS not involved the fovea group and MRS involved the fovea group.Mann-Whitney U test was used to compare age,SE and AL among different groups.Qualitative data were compared byχ^(2)test.Results In 371 eyes,there were 120 eyes in the simple PVA group;in the MRS group,there were 251 eyes,of which 208 eyes were in the PVA combined with MRS group.There were 33,27,3,14,12,56,28,and 7 eyes with or without retinal detachment,choroidal neovascularization,DSM,preretinal membrane,and simple superficial detachment of neuroepithelium in inner lamina,outer lamina,and FTMH,respectively.In 328 eyes with PVA,blood vessels and paravascular microfolds,paravascular

关 键 词：近视 视网膜劈裂症 血管旁病变 光相干断层扫描 

分 类 号：R778.11[医药卫生—眼科]