玻璃体积血的形态结构与玻璃体后脱离的图像特征

The morphologic structure of vitreous hemorrhage and posterior vitreous detachment

目的 探讨玻璃体积血的形态结构和治疗特点。方法 对 74例 (79只眼 )增生性糖尿病视网膜病变、视网膜血管炎、视网膜静脉阻塞所致玻璃体积血的临床资料进行比较分析。术前超声检查、术中手术显微镜观察患者的玻璃体形态特点 ,分析玻璃体与视网膜的关系。结果 所有患者均有不同程度的玻璃体后脱离 ,根据图像的形态特征可归纳为完全后脱离和部分后脱离两种。部分后脱离又分为“V”型、“L”型及后部玻璃体劈裂型 ,劈裂型多见于视网膜缺血性疾病的增生期。结论了解和掌握玻璃体后脱离及玻璃体劈裂的形态特点 ,可提高手术治疗的成功率并改善其预后。

Objective To investigate the morphologic structures of vitreous hemorrhage that may be beneficial to its treatment. Methods The clinical data of 74 cases (79 eyes) with vitreous hemorrhage resulting from proliferative diabetic retinopathy, retinal vasculitis and retinal vein occlusion in December 1995 to January 2000 and having undergone vitrectomy were studied retrospectively, which focused on the morphologic characteristics of vitreous body by B-scan, surgical microscopy and surgical manipulation, to evaluate the relation of retina and vitreous body in order to discern the relationships among the retina, neovascular fibromembrane and the posterior hyaloid surface. Results Posterior vitreous detachment (PVD) in various degrees was observed in all the cases. The morphologic character was classified as the complete and partial vitreous detachment. The latter one can be subdivided into 'V', 'L' types and posterior vitreoschisis that was not rarely seen in the proliferative phase of ischemic retinopathy. Conclusions To evaluate the characteristics of posterior vitreous detachment and vitreoschisis may provide valuable information for vitreoretinal surgery, elevate the rate of success and improve the prognosis of the surgery.