高度近视周边视网膜病变的早期治疗

Early treatment of peripheral retinal lesions in high myopia

目的对高度近视周边视网膜病变进行早期筛查及治疗。方法对近视度数≥-6.00D以上的高度近视患者进行周边眼底检查,若发现视网膜裂孔及格子样变性,及时行视网膜激光光凝术。结果 350例患者695只眼:周边视网膜格子样变性83眼,占11.94%;视网膜干性裂孔43眼,占6.19%;视网膜格子样变性合并干性裂孔26眼,占3.74%;视网膜马蹄形裂孔合并局部视网膜浅脱离6眼,占0.86%。对格子样变性及视网膜干性裂孔行预防性氩离子激光光凝术,术后1个月及6个月复查眼底,见变性及裂孔区封闭良好,激光色素斑形成明显。另视网膜马蹄形裂孔合并局部视网膜浅脱离6眼行激光光凝术后观察,其中4眼裂孔封闭,视网膜复位,2眼激光术后视网膜未复位,行巩膜外垫压术后视网膜复位。结论高度近视患者为视网膜变性或裂孔发生的高危人群,需尽早详细检查周边部视网膜。

Objective Early screening and treatment of peripheral retinal lesions in high myopia. Method On the degree of myopia-6.00D,when myopia patients had fundus examination,if it is found that there were the retinal hole and the lattice degeneration,then timely laser photocoagulation, ltesults 695 eyes in 350 patients had peripheral retinal lattice degeneration in 83 eyes,accounting for 11.94%;retinal hole in 43 eyes,accounting for 6.19%,lattice degeneration of retinal dry holes in 26 eyes,accounting for 3.74%, retinal horseshoe hole combined with local shallow retinal detachment in 6 eyes （0.86%）.Preventive argon ion laser photocoagulation had on the lattice degeneration and retinal dry hole.Postoperative ocular fundus examinations did after one months and six months,the peripheral retinal degeneration and dry hole area had good sealing and laser pigment spot obviously formed. In other retinal horseshoe shaped tears holes combined with local retinal detachment 6 eyes,they were treated with argon laser photocoagulation surgery.4 eyes with retinal hole had closure, the retina was completely reattached.2 eyes after laser surgery,the retina was not reset,retinal restoration after scleral buckling surgerys. Conclusion High myopia patients who are at high risk of retinal degeneration or rupture,they need to check the surrounding retina as early as possible.