病理性近视眼继发视盘周围视网膜脱离的临床分析(英文)

The clinical spectrum of localized peripapillary detachment in pathologic myopia

目的:描述病理性高度近视眼视盘周围局限性视网膜脱离,分析这一新认识的眼底病变发生的原因。方法:2002-12/2004-01 间,7 例 10 眼被确认存在视盘周围局限性视网膜脱离,本文评价了其 O C T、FA/IC G A 和m fER G 的临床特征。结果:视盘周围视网膜脱离不是任何患者就诊检查的原因,视力减退或矫正视力低的原因是相对严重的近视性视网膜脉络膜萎缩、C N V 、黄斑前膜形成和弱视。5 只患眼表现为 1 型后巩膜葡萄肿,其视盘周围视网膜脱离均位于视盘的鼻侧半,而另 5 只患眼表现为 3 型或 2 型葡萄肿,其视盘周围视网膜脱离均位于视盘的非鼻侧半,统计学上存在差异 (P =0.01)。所有患眼的视盘周围视网膜脱离区域均为后巩膜葡萄肿累及。结论:病理性近视眼的视盘周围视网膜脱离很可能是后巩膜葡萄肿的一个良性并发症。

AIM： To report the clinical manifestations of localized peripapillary detachment in pathologic myopia and to evaluate its underlying associations and causes. METHODS： From December 2002 to January 2004, 10 eyes from 7 patients with high myopia were identified to have localized peripapillary detachment by optical coherent tomography （OCT）. The features were described together with the fundus fluorescein angiography, indocyanine green angiography and multifocal electroretinogram. RESULTS： Localised peripapillary detachments did not cause any symptoms by themselves and all the lesions were recognized because of other ocular problems. The areas of peripapillary detachment were all located within the posterior staphyloma. In the 5 eyes with type 1 staphyloma, the locations of detachment were all in the nasal half of the peripapillary area. In the other 5 eyes with type 2 and 3 staphyloma, the locations of detachment were all in the non-nasal peripapillary area. The difference between these two groups was statistically significant （Fisher＇s exact test, P= 0.01）. CONCLUSION： Peripapillary detachment is probably a benign complication of posterior staphyloma in pathologic myopia. The site of peripapillary detachment is affected by the location of staphyloma and OCT is important in making the diagnosis.