高度近视眼发生玻璃体后脱离的临床研究

Study on the Posterior Vitreous Detachment in Patients with High Myopia

目的 探讨高度近视眼玻璃体后脱离(posteriorvitreousdetachment,PVD)的发生、发展,与高度近视人群的年龄、眼轴长度、脉络膜视网膜萎缩及玻璃体改变之间的相互关系。方法 对高度近视组(≥-8.0D)61例110只眼和对照组(≤-3.0D)68例119只眼进行了以下检查:间接眼底镜下观察玻璃体,检查后极部近视性脉络膜视网膜萎缩程度;B超声进一步检查玻璃体状况;A超声测量眼轴长度。对获得的数据进行统计分析处理。结果 高度近视组110只眼中86只眼(78.2%)出现PVD,其中5只眼(5.8%)出现视网膜裂孔合并视网膜脱离。高度近视眼组PVD发生率和玻璃体液化、混浊的发生率均显著高于对照组(P<0.0001)。高度近视组PVD的发生率随年龄的增长而增高,随眼轴长度的增长而增高(r=0.9997,P<0.05)。对照组PVD和玻璃体液化、混浊的发生率随着年龄的增长而增加(P<0.05)。结论 本研究的结果表明,高度近视眼人群PVD出现的年龄早,发生率随着年龄和眼轴长度的增加而增高。近视度数小于-3.0D、正视眼和远视眼的人群,随着年龄的增长PVD发生率同样增高,PVD是导致视网膜裂孔乃至视网膜脱离的主要因素。

To access the development of posterior vitreous detachment(PVD) related to age,axial length of the eye,vitreous changes as well as the myopic chorioretinal manifestation in patients with high myopia. Methods The vitreous status of 61 consecutive patients with high myopia(≥-8.0 D and axial length ≥26.0 mm) 110 eyes and 68 controls (≤-3.0 D) 119 eyes were examined with biomicroscopic slit lamp and B scan ultrasound.The myopic chorioretinal changes at the posterior pole were examined by indirect ophthalmoscope.The axial length of the eye was measured by A scan ultrasound.The incidence of PVD was evaluated by Chi square test. Results The incidence of PVD in patients with high myopia increased with age.Its overall incidence was significantly higher than that in the controls (78.2% vs 31.1%, P< 0.001).In addition,the onset of PVD in patients with high myopia occurred much earlier in age than that in the control group.Axial length was an important factor responsible for the development of PVD in patients with high myopia.The incidence of PVD and age were highly correlated ( r=0.9997,P<0.05). Retinal detachment occurred in 5 eyes in the patients with high myopia. Conclusions The results in the present study suggested that the incidence of PVD in patients with high myopia,increased with axial length of the eye and age.Vitreous changes are characteristic findings associated with high myopia,which was also involved in the development of PVD.