高度近视患者黄斑病变分型与视网膜劈裂的关系

Investigation of Myopic Maculopathy Classification and Its Relationship with Retinoschisis in Highly Myopic Eyes

目的:观察高度近视患者黄斑病变国际分型特征及其与视网膜劈裂之间的关系。方法:回顾性系列病例研究。收集2015年10月至2017年12月于上海交通大学附属第一人民医院眼科门诊就诊的116例(174眼)高度近视患者的病史资料和眼科检查信息,所有患者均接受眼底照相及高清OCT扫描检查,对图像进行分析评价。计量资料采用独立样本t检验或单因素方差分析。计数资料的比较采用Fisher's精确概率法。结果:116例(174眼)高度近视患者根据眼底彩照图像特征可分为5型:C0无近视退行性病变型(10眼)、C1豹纹状眼底病变型(74眼)、C2弥漫视网膜脉络膜萎缩型(36眼)、C3片状视网膜脉络膜萎缩型(25眼)、C4黄斑萎缩型(29眼)。其中70眼(40%)合并视网膜劈裂,均发生在C1、C2、C3、C4型中,其中C2型的发生率(58%)最高。结论:基于眼底彩照的国际分型结合OCT显示弥漫视网膜脉络膜萎缩型高度近视黄斑病变发生视网膜劈裂的可能性大。

Objective:To study the correlation between retinoschisis and different types of fundus disease in high myopia and evaluate the different types of morphologic characteristics in highly myopic eyes.Methods:In this retrospective study,116 patients(174 eyes)with high myopia from the outpatient department were included from October 2015 to December 2017.All participants underwent standardized medical interviews and ophthalmic examinations.An independent samples t test or one-way ANOVA were used to compare the measurement data.A chi square test(Fisher's exact probability method)was used to compare the numerical data.Results:There were five types of fundus disease shown on the fundus photographs:C0,no macular lesions in 10 eyes;C1,tessellated fundus in 74 eyes;C2,diffuse chorioretinal atrophy in 36 eyes;C3,patchy chorioretinal atrophy in 25 eyes and C4,macular atrophy in 29 eyes.Retinoschisis was detected in 70 eyes(40%)among eyes with C1,2,3,and 4,and the incidence of retinoschisis was highest in C2(58%).Conclusions:The International Classification based on fundus color photography combined with OCT shows the highest prevalence of retinoschisis in highly myopia patients with diffuse chorioretinal atrophy.