高度近视黄斑出血荧光素眼底血管造影改变与辨证论治关系的初步研究

Study on the relationship between the changes in fundus fluorescence angiography and determination of treatment based on differentiation of syndrome in high myopia with macular hemorrhage

目的探讨高度近视黄斑出血荧光素眼底血管造影改变与辨证论治的关系。方法回顾性分析我院门诊25例高度近视黄斑出血病例,共分两型:单纯型黄斑出血及新生血管膜型黄斑出血。辨证为肝肾阴虚、阴虚火旺和脾气虚弱。结果25例(25眼)高度近视黄斑出血的FFA及ICGA中不伴CNV的黄斑出血14眼,伴有CNV的黄斑出血11眼。不同类型的黄斑出血均为虚证,并以肝肾阴虚证为主。结论高度近视黄斑出血以虚症为主,随年龄增长证型有所改变,可有虚中夹实。其中伴或不伴CNV组患者均与肝肾阴虚证有密切关系,同时与阴虚火旺证和脾气虚弱证有关。

OBJECTIVE To study the relationship between the changes in the fundus fluorescence angiography （FFA）and determination of treatment based on differentiation of syndrome in patients with high myopia. METHODS Twenty- five high myopia with macular hemorrhage cases were retrospectively analyzed and classified into 2 subtypes： simple macular hemorrhage subtype and macular hemorrhage with CNV subtype. According to differentiation of syndromes, 3 disease types were divided, those were ganshenyinxu（ 肝肾阴虚）, yinxuhuowang（阴虚火旺）, and piqixuruo （脾气虚弱）. RESULTS Among 25 eyes, 14 were simple macular hemorrhage with no CNV, 11 were macular hemorrhage with CNV under FFA and ICGA. They were all deficiency syndrome and mainly were ganshenyinxu（肝肾阴虚）. CONCLUSIONS Myopic macular hemorrhage was mainly belonged to deficiency syndrome, but the disease type may change into deficiency syndrome accompanied with excess syndrome along with the growth of age.