121例“飞蚊症”患者临床分析

Clinical analysis of 121 ocular floater cases

目的通过对眼部近期出现"飞蚊症"患者的各种眼底表现进行临床分析,总结视网膜病变类型及出现几率,指导临床诊疗工作。方法选取2010年8月至2011年11月间于我院眼底内科门诊就诊的121例(134只眼)病程不超过1个月的"飞蚊症"患者,进行常规眼部检查、B型超声检查及散瞳后间接眼底镜眼底检查,对发现的眼底病变类型进行总结分析,根据病情分别予激光、手术或药物等治疗。结果 121例(134只眼)被检查者中提示玻璃体完全后脱离者78只眼(58.2%);散瞳后眼底检查发现阳性体征共45例(33.6%),其中单纯玻璃体积血8只眼,视网膜周边变性(无裂孔)12只眼,视网膜裂孔16只眼,后部葡萄膜炎1例(双眼),视网膜分支静脉阻塞3只眼(未累计黄斑区),视网膜局限性脱离3只眼,急性视网膜坏死1只眼。结论对于近期出现"飞蚊症"的患者,需要详尽的眼底检查及B型超声检查,多数有眼底病变者经过及时治疗预后良好,并且对此类患者应耐心解释,消除患者的紧张情绪和心理负担。

OBJECTIVE To analyze different fundus manifestations and to summarize the retinopathy types and the occurrence probabilities of ocular floater patients appeared recently.METHODS One hundred and twenty-one patients（134 eyes） who had suffered ocular floater less than one month were selected in this study from August 2010 to November 2011.Routine and fundus examinations with dilated pupils and B-scan ultrasonography were conducted and different manifestations were analyzed.Treatment including drugs,laser and surgery were performed for different diseases.RESULTS Among the selected 121 patients we found 78 eyes（58.2%） with posterior vitreous detachment by B-scan ultrasonography and 45 cases（33.6%） with abnormal fundus manifestations by indirect ophthalmoscope combining with supplementary lens and three-mirror contact lens.Among those there were eight cases of vitreous hemorrhage,twelve eyes of retinal lattice degeneration,sixteen eyes of retinal holes,one case of posterior uveitis（both eyes）,three eyes of branch retinal vein occlusion,three eyes of regional retinal detachment,one eye of acute retinal necrosis.CONCLUSIONS B-scan ultrasonography and fundus examinations with dilated pupils were necessary for patients with recent ocular floaters.Explanation and comfort with patience were needed to this kind of patients.