老年华人212只尸体解剖眼黄斑区组织病理改变

Histopathologic changes of macula lutea retinae in elderly Chinese autopsy eyes

目的 从组织病理学角度了解和分析老年华人黄斑部病变 ,探讨老年人视力障碍的原因。 方法 10 8例平均年龄为 78.4岁的老年华人系列尸体解剖所得的 2 12只眼球 ,取黄斑区全层眼球壁组织 ,作常规组织病理学检查。 结果 2 12只眼中 36 .3%有硬性玻璃膜疣 ,19.3%有软性玻璃膜疣 ,都伴有视网膜色素上皮 (retinal pigment epithelium,RPE)萎缩 ;5 .7%有 RPE渗出性脱离 ,视网膜或 RPE下新生血管膜形成 ,伴明显 RPE萎缩、感光细胞数量明显减少 ;3.2 %有后巩膜葡萄肿 ,巩膜、脉络膜变薄 ,色素上皮萎缩 ,感光细胞数量明显减少 ,平均眼轴长度 2 9.5 mm;2 .4%有白内障手术后的黄斑囊样水肿。 结论 老年性黄斑变性 (age- related macular degeneration,AMD)为本组老年华人尸体解剖眼黄斑区的主要病理改变 ,其次为病理性近视黄斑变性和老年性白内障术后黄斑囊样水肿。

Purpose To investigate the histopathologic changes of macula lutea retinae in the elderly Chinese population,and to provide information for the cause of visiual disturbance in an autopsy study. Methods Two hundred and twelve eyes from 108 consecutive cases of postmortem (mean age of 78.4 years old) sections of the area of macula lutea retinae were studied by histopathology. Results Among the 212 eyes,hard drusen were found in 36.3% of eyes and soft drusen in 19.3% of eyes.The eyes with both of the above mentioned 2 types of drusens were found to be combined with RPE atrophy and RPE detachment;and subretinal neovascularization were found in 5.7% of these eyes and they were associated with obvious RPE atrophy and photoreceptor loss;3.2% eyes had posterior scleral staphyloma showing thinning of the sclera and choroid,RPE atrophy and apparent photoreceptor loss;2.4%eyes showed CME with the history of cataract surgery. Conclusion The macular affections,age related macular degeneration,myopic macular degeneration and post operative cystoid macular edema are varying in number in the above mentioned order successively,in elderly Chinese at an autopsy study.