正确认识和掌握高度近视黄斑病变的诊疗方法，减少高度近视患者视功能损害

High myopia-related macular lesions： diagnosis and treatment

以近视眼中心凹劈裂、黄斑裂孔及黄斑裂孔性视网膜脱离、近视性脉络膜新生血管为代表的高度近视黄斑病变是影响高度近视患者视功能的主要原因之一。光相干断层扫描检查有助于提升高度近视黄斑病变的认知水平。选择合适的手术时机，解除玻璃体后皮质和内界膜对视网膜的牵拉，有利于恢复视网膜的弹性，使近视眼中心凹劈裂消失，促进黄斑裂孔的闭合和视网膜复位；而抗新生血管药物与光动力疗法和（或）糖皮质激素联合应用，则是治疗近视性脉络膜新生血管的发展方向。正确认识和掌握高度近视黄斑病变的诊疗方法和时机，采取针对性的干预措施，使其能够得到合理有效的治疗，是进一步减少高度近视患者视功能损害的关键。

High myopia is frequently associated with retinal degenerative changes （such as myopic foveoschisis, macular hole and its related retinal detachment, and choroidal neovascularization） which are the major causes of visual loss in high myopic eyes. Optical coherence tomography may help us to understand the macular lesions in high myopia. Peeling of internal limiting membrane and removal of posterior vitreous cortex at an appropriate time, are believed to facilitate restoring the retinal flexibility and resolution of myopic foveoschisis, and promote the macular hole closure and retinal reattachment. Antiangiogenesis treatment combined with photodynamic therapy and （or） corticosteroid therapy are the future options to treat myopic choroidal neovascularization. Correctly understanding and mastering the methods and timing of diagnosis and treatment of high myopia-related macular degeneration, and taking targeted interventions to enable patients to be rational and effective treated, are the keys to further reduce the damage of visual function in patients with high myopia.