老年人视网膜脱离的临床分析

A clinical analysis of senile retinal detachment

【摘要】目的探讨老年人视网膜脱离（RD）的发病特征、治疗方法及效果。方法收集185例（187眼）因RD接受手术治疗，年龄大于等于50岁者资料，对其临床特征进行回顾性分析。结果老年人RD的主要构成比：孔源性RD140眼（74．9％），牵引性RD46眼（24．6％）（其中牵引合并孔源性RD26眼，占总体RD的13．9％），渗出性RD1眼（0．5％）。另老年高度近视RD中黄斑孔性占61．0％。转诊患者中误诊率为11．4％。尽管末次手术视网膜复位率高达95．7％，但术后低视力及盲仍占86．6％。结论老年人RD主要与玻璃体后脱离的发生有关；老年高度近视RD多数由黄斑孔引起；老年人RD的误诊率较高；治疗遵从一般RD治疗的原则；术后低视力及盲所占比例较大。

Objective To investigate the clinical aetiological feature,treatment and effect of senile retinal detachment（SRD）. Methods The clinical data of retinal detachment in 187 eyes of 185 patients, undergone surgical treatment and whose ages were no less than fifty, were retrospectively analyzed. Results SRDs were classified as rhegmatogenous, tractional, exudative SRD. In our cases, those three types occu- pied 74.9% , 24.6%, and 0.5% respectively and there were 61.0% senile high myopic retinal detachment eyes resulting from a macular hole. Misdiagnosis rate of referrals was 11.4%. Final retinal reattachment rate reached 95.7%, while postoperative cases with ＂low vision or blindness＂ occupied 86.6%. Conclusion The main cause of SRD is posterior vitreous detachment. Senile myopic retinal detachment is intensively relat- ed to a macular hole. The rate of misdiagnosis is high. A general therapeutic principle of retinal detachment is suitable for SRD. Lots of ＂low vision or blindness＂ patients can be found in the postoperative outcomes of SRD.