高度近视不同部位视网膜劈裂的OCT图像特征

The location and morphological changes of retinoschisis in high myopia by OCT

目的观察高度近视视网膜劈裂发生的部位与活体病理形态学改变特点。设计同顺性队列研究。研究对象高度近视患者71例(95眼),平均年龄(52.99±11.1 3)岁;男25例(32眼),女46例(63眼)平均屈光度(-12.2±3.18)D,平均矫正视力0.24±0.28。方法用Stratus OCT或Cirruu OCT对高度近视患眼进行黄斑区、后极部和视乳头进行水平和垂直线性扫描,观察视网膜劈裂发生的部位和形态学改变。结果高度近视95眼中,发生后极部视网膜劈裂75眼(78.9%),其中发生4个象限、2个象限和1个象限视网膜劈裂分别是32眼(42.7%)、5眼(6.7%)和38眼(50.7%)。55眼(60.4%)发生视乳头周围视网膜劈裂,35眼(63.6%)同时有后极部视网膜劈裂。75眼后极部视网膜劈裂中,5眼(6.7%)为内层劈裂,27眼(36.0%)为外层劈裂;32眼(42.7%)为全层劈裂;12眼(16.0%)为微皱褶改变;12眼同时合并黄斑区视网膜劈裂;55眼(57.9%)黄斑区出现其他病理形态改变。结论高度近视视网膜劈裂可发生于黄斑区、后极部和视乳头周围视网膜;可发生在视网膜内层、外层和全层;可以是弥散性的也可以是局限性的。

Objective To study the location and the morphological changes of retinoschisis in high myopic eyes. Design Retrospective cohort study. Participants Ninety five eyes of 71 patients with high myopia were included in present study, their average age was 52.99±11.13 years old. There were 25 men （32 eyes） and 46 women （63 eyes）. And there were 52 right eyes and 43 left eyes. The average refractive error was -12.2±3.18 D. 3lie mean best-corrected visual acuity was 0.24±0.28. Methods Stratus OCT or Cirrus OCT was used to perform with horizontal and vertical scanning on the macula, posterior polar area and optic disc of the eyes with high my- opia. The location and the morphological changes of retinoschisis were studied. Results In these 95 eyes with high myopia, there were 75 eyes （78.9%） with retinoschisis in posterior polar area, among which there were 32 eyes （42.7%） with 4-quardrant involvement, 5 eyes （6.7%） with 2-quardrant involvement and 38 eyes （50.7%） with l-quardrant involvement. There were 55 eyes （60.4%） with retinoschisis around the optic disc, among which there were 35 eyes （63.6%） accompanied with retinoschisis in posterior area. In the 75 eyes with retinoschisis in posterior polar area, inner retina was involved in 5 eyes （6.7%）, outer retina was involved in 27 eyes （36.0%）, and full retina was involved in 32 eyes （42.7%）; and there were 12 eyes （16.0%） showed microfold changes, 12 eyes accompanied with foveoschisis, 55 eyes （57.9%） accompanied with other pathological changes on the macula. Conclusions The location of retinoschisis in high myopia eyes could be on the macula, posterior polar area and around the optic disc, which may involve inner retina, outer retina or full retina. And it could be a diffuse change or a focal change.