有症状的急性玻璃体后脱离的超声探查分析

Analyses of B scan in symptomatic acute posterior vitreous detachment (PVD)

目的探讨利用B型超声检查和眼底检查相结合来观察急性PVD时的玻璃体和视网膜的情况。方法通过对2003.7-2003.10期间有症状的急性PVD患者55人55眼进行临床检查和分析。所有患眼均经B超作细致的全周探测,之后由检眼镜、VOLK90D、三面镜检查眼底情况。结果55眼经B超检查发现完全性PVD有41眼,部分性PVD为14眼。后界膜大多表现为后部纤细的中低回声光带,柔软并具有明显的后运动度。B超发现周边部存在中高回声条块和后界膜相连,并怀疑为视网膜裂孔的有8眼,经眼底检查确诊的有5眼。B超发现有7眼增厚的后界膜对视网膜有牵引感,经眼底检查均未发现裂孔。有一眼眼底检查发现周边马蹄形干孔,而超声检查未注意到。结论B超是探查PVD完全性和视网膜裂孔最简单、有效的方法,可以为诊治和预后提供全面的指导。大多完全性PVD的玻璃体有明显的液化、塌陷。在部分性PVD患眼,则需重视后界膜与视网膜粘连处的变化。

Objective To observe vitreous and retinal changes at acute PVD by B-scan combined with fundus examination. Methods Fifty-five eyes with symptomatic acute PVD were analyzed and examined with ophthalmoscope, VOLK90D and 3-mirror lens after delicate B scan from July 2003 to October 2003. Result 41 eyes were found with complete PVD and 14 eyes with partial PVD. Most posterior vitreous cortex reflected as posterior slim soft bend with mid to low echo and obvious activity. 5 of 8 eyes suspected with retinal tears under B scan were diagnosed after fundus examination. Peripheral horse-shoe tear without RD missed in B scan was found in 1 eyes after fundus examination. Conclusion B scan is a simple and effective method to explore the completeness of PVD and retinal tear￡ provide direction in therapy and prognosis. Most vitron with complete PVD has obvious liquefaction and collapse. The change of vitreous-retina adhesion must be recognized in partial PVD.