近视眼周边视网膜变性的特点及预防性光凝

Characteristics and treatment of peripheral retinal degeneration in myopia

目的探讨近视眼周边视网膜变性的特点以及氩离子激光预防性光凝的效果。方法近视眼503例（984眼）。充分散瞳后验光，并依近视程度分为3组，用检眼镜以及裂隙灯显微镜联合三面镜或全视网膜镜详细检查眼底，记录周边部视网膜变性病灶的数量、特点和位置，并进行统计分析，对伴严重视网膜变性者予以氩离子激光光凝。结果984眼中周边部视网膜变性155眼（15．75％），周边部视网膜变性百分率：I组为8．36％；11组为15．90％；Ⅲ组为22．75％。双眼的变性区分布有对称性，百分率为60．65％。变性区以不压变白和树枝样变性多见。对视网膜变性较严重者施行了眼底激光光凝。复诊时见激光斑反应明显、裂孔稳定，局限性浅脱离者经2—4次激光光凝后视网膜完全平复，在2年内复诊中无1例视网膜脱离发生。结论近视眼周边视网膜变性的检出率随近视屈光度的增加而增高，且有对称性，对周边视网膜变性进行激光光凝可以防止视网膜脱离的发生。

Objective To discuss characteristics of peripheral retinal degeneration in the eye with myopia and the effect of treatment with Argon laser photocoagulation. Methods Nine hundred and eighty four eyes of 503 cases with myopia were examined. They were divided into 3 groups according to the myopic degree. The methods of examination included noncycloplegic and cycloplegic refraction, direct ophthalmo- scope and slit-lamp microscopy combined with three-mirror contact lens or panretinoscope. Quantity, charac- teristics and distributed rule of peripheral retinal degeneration were recorded and analyzed. The laser photo- coagulation was performed in order to strengthen the retina with severe peripheral degeneration. Results 155 eyes had peripheral retinal degeneration in the 984 eyes （ 15.75% ）. Incidence rate of peripheral retinal degenerations was 8.36%, 15.90% and 22.75% in the three groups, respectively. There was a symmetry in distribution of peripheral retinal degeneration in bilateral eyes of 47 cases （60.65%）. The most common peripheral retinal lesions were white without pressure and branch degeneration. The pathological changes were treated effectively by laser photocoagulation for more than three weeks, and eventually the holes were firmly closed, the limitations of degeneration were photocoagulated reliably. No new holes or retinal detach- ment occurred. Conclusion There is significant difference in relevance ratio for peripheral retinal degener- ations among the different diopter myopia, the ratio is increasing with the increase of myopic diopter. There is a symmetry in bilateral eyes. To prevent retinal detachment effectively, laser photocoagulation should be performed in time on the peripheral retinal degeneration in the eye with myopia.