努力加深对近视牵引性黄斑病变的认识,合理开展手术治疗

Enhance the cognition of myopic traction maculopathy to select the surgical approach reasonably

近视牵拉性黄斑病变(MTM)是包括玻璃体黄斑牵拉、黄斑劈裂和黄斑裂孔在内的一类疾病的总称。后巩膜葡萄肿在MTM的发生发展中起着至关重要的作用。目前对于MTM的手术时机及手术方式尚无统一标准。基于OCT检查的黄斑牵引性病变分级及视功能影响程度是现阶段判断手术时机的重要依据。微创玻璃体切割手术已广泛用于治疗MTM,但对于眼轴较长者,其手术操作复杂,效果不理想。黄斑扣带手术可有效缓解后巩膜葡萄肿引发的牵拉,但该手术有一定的学习曲线,手术材料有待改进和完善,而且需更多循证医学证据。我们相信,随着临床对MTM的不断认识,手术治疗会更加合理化,将取得更好的治疗效果。

Myopic traction maculopathy is a general term for a class of diseases including vitreomacular traction,foveoschisis,and macular hole.Posterior staphyloma plays a vital role in the occurrence and development of myopic traction maculopathy.At present,there is no uniform standard for the timing and method of surgery for myopic traction maculopathy.Based on OCT examination,the classification of traction maculopathy and the degree of visual function damage are important basis for judging the timing of surgery at this stage.Pars plana vitrectomy has been widely used in the treatment of myopic traction maculopathy,but for those with a long axis,the operation is complicated and the effect is not ideal.Macular buckling can effectively alleviate the traction caused by posterior staphyloma,but this surgery has a certain learning curve for clinicians,surgical materials need to be improved and perfected,and more evidence-based medical evidence is needed.We believe that with the continuous clinical understanding of myopic traction maculopathy,surgical treatment will be more rationalized and better treatment results will be achieved.