外伤性黄斑裂孔的法医学鉴定

Forensic identification of traumatic macular hole

目的探讨外伤性黄斑裂孔的特点及法医学鉴定要点。方法选择2014年1月~2016年12月期间,一所省级眼科医院33例(共33只眼睛)有确切眼外伤史的黄斑裂孔的案例资料进行回顾性研究,所有案例均行详细的常规视力、屈光度、VEP、ERG、裂隙灯、彩色眼底照相、视野、眼压、FFA、OCT等眼科检查。结果黄斑裂孔依据损伤程度可将其分为全层裂孔和板层裂孔,出现裂孔的时间不一,裂孔有自愈的可能,视力下降有可能恢复提高,损伤程度可为轻伤二级、轻伤一级、重伤二级。结论外伤性黄斑裂孔具有一定特征性,由裂孔引起的视力下降可以影响鉴定结论,鉴定时限为3~6月,部分案例可依具体情况延长至满6个月,OCT是检查的重要手段。

Objective To investigate the characteristics of traumatic macular hole and the key points of forensic identification.Methods From January2014 to December 2016,a provincial eye hospital in 33 cases（33 eyes） cases have definite ocular trauma history of macular hole were analyzed retrospectively.All cases were performed with visual acuity,diopter,VEP,ERG,slit lamp,fundus photography,visual field and intraocular pressure,FFA,OCT and other eye examination.Results Macular hole based on the damage degree can be divided into full-thickness hole and lamellar macular hole,hole appeared time,tear the possibility of healing,decreased visual acuity may improve recovery,the degree of injury to a minor two,minor one,injured two.Conclusion Traumatic macular hole has certain characteristics,caused by the hole decreased visual acuity can affect the appraisal conclusion,the time limit for the identification of 3~6 months,according to the specific circumstances of part of the case is extended to the full 6 months,OCT is an important means of inspection.