光学相干断层扫描对黄斑部视网膜劈裂的观察

Optic coherence tomography study of macular retioschisis

目的加深对黄斑部视网膜劈裂的了解。方法对行光学相干断层扫描(OCT)检查发现黄斑部存在视网膜劈裂的患者行进一步检查分析。检查包括最佳视力、前置镜、屈光度、超声波、荧光素眼底血管造影(FFA)和视觉电生理等。结果经OCT诊断为黄斑部视网膜劈裂者116眼,其中94眼为病理性近视、17眼为先天性遗传性黄斑部视网膜劈裂,5眼为视盘小凹。视网膜劈裂可发生在视网膜神经上皮层内、中、外三个部位,外层最常见;不同原因导致的劈裂其病变的层次和范围各不相同。结论黄斑部的视网膜劈裂可发生在视网膜的多个层次。

Objective The report and study on retioschisis is curried out only in congenital retioschisis before because of less in vivo examination method. Optic coherence tomography（OCT） is an effective appoach to the in vivo observation of retina. The purpose of this study was to improve our understanding of retinoschisis. Methods The 127 eyes of 109 patients with macular schisis confirmed by OCT in Eye and ENT Hospital in January 2005 to January 2007 were included in the study. Some clinical data such as visual acuity, fundus examination, fundus fluorescence angiography （ FFA ） , diopter, ultrasound and visual physiology were further analyzed,and OCT was performed and analyzed in these eyes. Results Macular schisis was found in 116 eyes,including 94 （81% ） eyes with pathological myopia, 17 （15 % ） eyes with X-linked congenital retinoschisis, and 5 （4%） eyes with optic pits. In 94 eyes with pathological myopia, retinal schisis were found in the neural retina, classifing into inner （36 eyes） ,middle（ 16 eyes） and outer schisis（89 eyes）,and two types of schisis were simultaneously found in 40 eyes. In 17 eyes with X-linked congenital retinoschisis,major retinal schisis occurred in middle layer, and in 5 eyes with optic pits,the inner and outer schisis were coexsited in 4 eyes. The retinoschisis presented in different layers and locations of posterior retina on OCT upon above different reasons. FFA and visual physiology examination demonstrated the retinoschisis in these patients. Conclusion Retinoschisis at the macular area was not rare at clinic,and the schisis may locate at different part of the neural retina.