高度近视性黄斑出血的临床观察

Clinical observation of macular hemorrhage in high myopia

观察高度近视性黄斑出血的临床特点和探讨其治疗方法。方法 :对确诊为高度近视性黄班出血的 2 8例 32眼分别作视力、矫正视力、眼前节、眼底、A/B超、眼底彩照和眼底荧光血管造影 ( fundus fluorecein angiography,FFA)等检查 ,给予中西药物治疗 ,随访观察 2～ 2 6个月 (平均 16个月 )。结果 :经 FFA检查 32眼中 2 8眼 ( 87.5 % )为单纯型黄斑出血 ,其中 2 5眼( 89.3% )伴有漆裂样纹。出血经治疗多在 15天至 2个月吸收 ;另外 4眼 FFA显示为脉络膜新生血管出血 ,最终均因反复出血 ,后巩膜葡萄肿和脉络膜萎缩而预后较差。结论 :高度近视性黄斑出血分单纯型和脉络膜新生血管型 ,前者出血吸收快 。

To observe the clinical features of the macular hemorrhage in high myopia and to search for therapy fot it.Methods:32 eyes of 28 patients of high myopia with macular hemorrhage were examined visual acuity,corrected visual acuity,anteriors segment of eyes,fundus,A or B ultrasonic scan,fundus color photography and fundus flurescein angiography(FFA),and were treated with both the West and Chinese medicine.Those patients were followed up for 2 to 26 months(the average of 16 months).Results:Among the 32 eyes examined FFA,28(87 5%)eyes were simple type hemorrhage of macular.25(89 3%)of the 28 eyes showed Lucquer crack.The hemorrhage of simple type disappeared after treated for 15 days to 2 months.FFA of 4 eyes showed choroidal neovascular.The prognosis of them was bad because of repeated hemorrhage,staphyloma of posterior scleral and choroidal atrophy finally.Conclusion:Macular hemorrhage of high myopia were divided into the simple type and the choroidal neovascular type.The hemorrhage of the former disappear more quickly.The prognosis of the latter is bad because visual acuity is severely damaged from repeated hemorrhage.