有裂孔的视网膜变性的临床特征和氩激光治疗

Clinical characteristics of retinal degeneration with retinal holes and the therapeutic effect of argon laser therapy

目的探讨有裂孔的视网膜变性的临床特征和氩激光治疗效果。方法回顾性分析本院210例224只眼相应视网膜变性的氩激光治疗资料,并与同期尚无裂孔的视网膜变性氩激光治疗对照。结果有裂孔的视网膜变性患者,小于60岁者89.7%,男性53.3%,女性46.7%,格子样变性65.6%,变性范围≤1个象限者87.5%,卵圆形裂孔60.7%,伴有局限性视网膜浅脱离者23.7%。与尚无裂孔的视网膜变性患者相比,≥35岁、囊样变性、视网膜纵向小皱襞、有自觉症状的患眼构成比明显偏高,而氩激光视网膜脱离预防性治疗对已出现局限性孔源性视网膜脱离的视网膜变性患者疗效明显偏低(P<0.01)。结论有裂孔的视网膜变性常见于青壮年,多数患者为1个象限内的格子样变性;裂孔多数为卵圆形,多不伴有视网膜脱离;裂孔没有明显的性别差异,多数没有自觉症状。不伴有视网膜脱离的视网膜单纯性裂孔的视网膜变性,氩激光视网膜脱离预防性治疗可获得满意疗效。

Objective To investigate the clinical characteristics of retinal degeneration （RD） with retinal holes and the therapeutic effect of argon laser therapy. Methods The data of argon laser therapy in 210 RD patients （224 eyes） with retinal holes who underwent the treatment in our department were retrospectively analyzed, which was compared with the data of argon laser therapy in 173 RD patients （198 eyes） without retinal holes. Results In RD patients with retinal holes, 89.7% of the patients were less than 60 years old （53.3% males and 46.7% females）. Grid like degeneration was found in 65.6% of the patients in whom 87. 5% had the range of degeneration less than 1 quardrant. There were oval shaped holes in 60.7% of the patients and accompanied with limited rhegmatogenous retinal detachment （LRRD） in 23. 7%. Compared with RD patients without retinal holes, the ratio of patients with the age of≥35 years, cystic degeneration, retinal lengthways small plica, and subjective symptoms was higher in RD patients with retinal holes; while the therapeutic effect of argon laser therapy on patients with LRRD was obviously less than whom without retinal holes （P〈0. 01 ）. Conclusions RD with retinal holes often occurs in youth, most of whom have grid-like degeneration with the range of ≤1 qua drant. The major types of retinal holes are oval-shaped degeneration without retinal detachment. There was no sex difference in RD patients with retinal holes and most of the patients have no subjective symptoms. The therapeutic effect of prophylactic argon laser therapy on RD patients with retinal holes but no retinal detachment is satisfying.