玻璃体积血合并视网膜裂孔患者的临床特征分析

Clinical analysis of vitreous haemorrhage associated with retinal tears

目的:研究玻璃体积血合并视网膜裂孔患者的临床特点,为早期干预和改善患者预后提供指导建议。方法:回顾性分析2016/12-2018/12我院收治的105例105眼玻璃体积血合并视网膜裂孔患者,其中男54例,女51例,分析其临床特征,治疗效果和影响预后的相关因素。结果:在105眼中共有151个视网膜裂孔,其中82个裂孔位于颞上象限(54.3%),28个位于鼻上象限(18.5%),27个位于颞下象限(17.9%),14个位于鼻下象限(9.3%)。视网膜裂孔的形状以马蹄形为主(77.5%)。裂孔直径1/8~4PD之间,最常见的为1PD大小。76例(72.4%)视力优于或等于术前视力。术后矫正视力与术前比较无差异(P>0.05);扣带组与玻璃体切除组相比,视力改善无差异(P>0.05)。结论:视网膜裂孔是玻璃体积血的重要原因。视网膜裂孔多位于颞上象限,以马蹄形为主。全面了解视网膜裂孔相关的玻璃体积血的临床特点,有助于早期发现视网膜裂孔,避免严重并发症的产生。如果术前最佳矫正视力(LogM AR)小于1.6并且光定位小于1m,术后视力则差。如果视网膜脱离累及黄斑,特别是伴增殖性玻璃体视网膜病变的患者预后也较差。

AIM:To study the clinical characteristics of vitreous hemorrhage associated with retinal tears,so as to provide suggestions for early intervention and improving the prognosis of patients.METHODS:This was a retrospective study.Totally 105 patients(105 eyes)with vitreous haemorrhage associated with retinal tears treated at our hospital from December 2016 to December 2018 including 54 males and 51 females,of who the clinical characters,therapeutic effcet and prognostic facors were retrospectively analyzed.RESULTS:Among the 105 eyes(151 retinal tears),82 tears were located in the superotemporal area(54.3%),28 tears were located in the superonasal area(18.5%),27 tears were located in the inferior temporal area(17.9%),and 14 tears were located in the inferior nasal area(9.3%).The shape of the retinal tears was mostly horseshoe(77.5%).The diameter of the tear was between 1/8-4 papillary diameter(PD),most commonly is 1 PD.Seventy-six patients(72.4%)had visual acuity better than or equal to their preoperative vision.There was no significant difference in corrected visual acuity pre-and postoperative(P>0.05),and there was no statistically significant improvement in visual acuity between the buckling procedure group and the vitrectomy group(P>0.05).CONCLUSION:Retinal tear is an important cause of vitreous haemorrhage.Retinal tears were mostly located in the superotemporal area with horseshoe shape.A comprehensive understanding of the clinical characteristics of rhegmatogenous vitreous haemorrhage helps to detect tears early and avoid serious complications.Patients had preoperative best corrected visual acuity(BCVA)(LogMAR)less than 1.6 and light perception less than 1 m,have poor postoperative vision,as do patients with retinal detachment involving the macula especially along with proliferative vitreoretinopathy(PVR).