高度近视眼后极部眼底病理改变  

The pathologic changes of posterior pole in high myopia

作　　者：张薇[1] 牛改玲[1] 高立新[1] 孙心铨[2] 杨硕[1] 许帮丽[1] 刘颖[1] 

机构地区：[1]首都医科大学附属北京朝阳医院,北京100020 [2]北京中日友好医院

出　　处：《眼科》2003年第4期209-210,T013,共3页Ophthalmology in China

摘　　要：目的 :通过眼底荧光血管造影 (FFA)和吲哚青绿血管造影 (ICGA)观察 2 1例高度近视眼底后极部漆裂纹状病变、黄斑出血、Fuchs斑 ,以探讨高度近视眼底后极部的病理改变。方法 :回顾分析 2 1例 (42只眼 ) ,屈光度为 - 6D以上的高度近视眼底。均行彩色眼底照相、FFA、ICGA检查。将病例分为黄斑无出血组、黄斑出血组。结果 :无出血组 2 9只眼在FFA检查中 4只眼有漆裂纹 ,占 1 3 79% ,在ICGA检查中有漆裂纹者 9只眼 ,占 31 0 3 % ,其中ICGA所见漆裂纹比FFA中数目更多且更长。出血组 1 3只眼中FFA显示有漆裂纹 7只眼占 53 85 % ,ICGA显示有漆裂纹 9只眼 ,占 69 2 3 % ,该组中有 1只眼IC GA未发现有脉络膜新生血管膜与漆裂纹。另有 3例黄斑出血的对侧眼有眼底后极部萎缩斑或Fuchs斑。结论 :高度近视眼黄斑出血是病程发展的自然过程 ,漆裂纹常预示有出血产生的可能。黄斑出血由于脉络膜新生血管向视网膜生长 ;也可能只有视网膜黄斑部毛细血管出血而非脉络膜新生血管形成。晚期新生血管膜机化 ,色素上皮细胞增殖。Objective:To study pathologic changes of high myopia by using FFA and ICGA to observe lacquer crack,macular hemorrhage and Fuchs spots of myopia.Methods:Retrospective study of a series of high myopia cases.Color fundus photography,FFA and ICGA were performed in 21 patients (42 eyes) with high myopia (≥6D).The patients were divided into 2 groups:with macular hemorrhage and without macular hemorrhage.Results:In 29 eyes of no hemorrhage group,lacquer cracks were seen in 4 eyes (13 79%) using FFA and in 9 eyes (31 03%) using ICGA.Lacquer cracks were more visible and appeared longer when observed with ICGA than with FFA.Of the 13 eyes with macular hemorrhage,lacquer cracks were found in 7 eyes (53 85%) using FFA and in 9 eyes (69 23%) using ICGA,and neither choroidal neovascular membrane nor lacquer cracks was found in 1 eye using ICGA.Another 3 patients of the macular hemorrhage group were found to have posterior pole atrophy and Fuchs spot in the contralateral eye.Conclusion:Macular hemorrhage is a natural process in pathologic myopia.Lacquer cracks often indicate the possibility of hemorrhage.It is possible that the macular hemorrhage is due to either choroidal neovascular growing into retina or retinal macular microvascular damage.Late in this process,the choroidal neovascularization organizes and pigment epithelium proliferates to form Fuchs spot.

关 键 词：近视 黄斑出血 新生血管化 脉络膜 Fuchs斑 

分 类 号：R778.11[医药卫生—眼科]