病理性近视劈裂眼玻璃体视网膜牵引征的OCT观察

Characteristics of the vitreoretinal traction syndrome with optical coherence tomography in pathological myopic retinoschisis

目的探讨病理性近视伴视网膜劈裂眼(RS)的玻璃体视网膜牵引征的光学相干断层成像(OCT)诊断价值。方法随机研究2009年9月～2010年4月华西医院病理性近视276眼(163例)的眼底改变,分析伴有视网膜劈裂的病理性近视53眼(42例)的玻璃体视网膜OCT图像特征。结果 OCT显示49眼(92.45%)有不完全脱离的玻璃体牵引视网膜体征,其中21眼(39.62%)后极部的视网膜有牵引性皱褶,11眼(20.75%)有视网膜黄斑局灶样弥漫性增厚,8眼(15.09%)有视网膜内界膜局团状增殖样改变,7眼(13.20%)呈玻璃体条索状强反光带牵引视网膜,2眼(3.77%)有牵引性黄斑中心凹假孔。病理性近视的高度近视患眼多引发内层视网膜劈裂,而超高度近视患眼常伴发视网膜外层劈裂或混合劈裂,两者比较差异有显著性(P<0.05)。结论伴视网膜劈裂的病理性近视眼普遍存在玻璃体牵引视网膜征。玻璃体视网膜牵引所致视网膜内层劈裂是病理性近视的早期病理退变,可通过OCT检查及时发现。

【Objective】 To study the OCT characteristics of the vitreoretinal traction syndrome in the retinoschisis of the pathological myopia.【Methods】 Prespective evaluated the fundus of pathological myopic in 163 cases（276 eyes） and analyzed the OCT characteristic of significant retinoschisis in 41 cases（53 eyes） from Sep.2009 to Apr.2010.【Results】 There were visible retinoschisis and vitreoretinal traction syndrome in 49 eyes（92.45%） in total.21 eyes（39.62%） were been observed gossamery virteous tractive membrane with normal configurative foveal and 11 eyes（20.75%） suffered from incrassated and edema retina with vitreous tractive syndrome.OCT found local internal retinoschisis with swollen tubercle pathological retina changes in 8 highly myopic eyes（15.09%）.There were distinct vitreoretinal traction-band inserted into retina in 7 eyes（13.20%） and pseudomacular hole in 2 eyes（3.77%）.The incidence of internal retinoschisis was higher in the highly myopic group than that in the extra-highly myopic group.There was a significant difference between the two groups（P 0.05）.【Conclusion】 The vitreoretinal traction syndrome always resulted in reinoschisis in pathogenesis myopia.The intenal retinoschisis,was occurred early than the external retinoschisis usually,was the early degenerative pathological degeneratin in process of pathological myopic disease.