病理性近视引起视力下降的影像学病因及护理干预措施分析

Analysis of Imaging Etiology and Nursing Intervention Measures of Visual Acuity Loss Caused by Pathological Myopia

目的 研究病理性近视引起视力下降的影像学病因及护理干预措施。方法 将医院从2018年2月-2021年2月收治的97例病理性近视引起视力下降患者纳入研究。通过彩色眼底照相判定漆裂纹,以频域光相干断层扫描、荧光素眼底血管造影、吲哚菁绿血管造影以及光相干断层扫描血管成像完成脉络膜新生血管(SNV)以及点状内层脉络膜病变(PIC)的评估,采用频域光相干断层扫描完成黄斑区视网膜劈裂(MRS)以及黄斑萎缩、裂孔、前膜的评估。对比病理性近视所致视力下降不同病因患者相关参数。结果 97例病理性近视引起视力下降的影像学病因按照占比从高到低的顺序分别为MCNV、漆裂纹、MRS、黄斑萎缩、黄斑前膜、黄斑全层裂孔、黄斑板层裂孔及PIC,占比分别为63.92%、38.14%、34.02%、30.93%、28.87%、11.34%、10.31%、2.06%。病理性近视所致视力下降病因为MCNV、漆裂纹、MRS、黄斑萎缩、黄斑前膜、黄斑板层裂孔、黄斑全层裂孔患者的年龄分别为(52.39±1.40)岁、(53.10±1.41)岁、(52.57±1.38)岁、(53.45±1.45)岁、(54.22±1.47)岁、(52.87±1.42)岁、(55.10±1.51)岁,均高于PIC患者的(31.07±1.03)岁;MCNV、漆裂纹、黄斑萎缩、黄斑板层裂孔、黄斑全层裂孔患者的视力分别为(0.55±0.13)LogMAR、(0.51±0.12)LogMAR、(0.60±0.14)LogMAR、(0.63±0.15)LogMAR、(0.52±0.11)LogMAR,均高于PIC患者的(0.35±0.10)LogMAR,而MRS及黄斑前膜患者的视力分别为(0.30±0.10)LogMAR、(0.29±0.08)LogMAR,均低于PIC患者的(0.35±10)LogMAR(均P <0.05)。结论 病理性近视引起视力下降的病因以黄斑区结构异常改变为主,其中又以MCNV最为多见,值得临床重点关注。

Objective To study the imaging etiology and nursing intervention measures of visual acuity loss caused by pathological myopia and analyze. Methods From February 2018 to February 2021, 97 patients with vision loss caused by pathological myopia admitted to the hospital were included in the study. Choroidal neovascularization(SNV) and punctate inner choroidal lesion(PIC) were evaluated by frequency domain optical coherence tomography, fluorescein fundus angiography, indocyanine green angiography and optical coherence tomography angiography. Frequency domain optical coherence tomography was used to evaluate MRS, macular atrophy, hiatus, and anterior membrane. The relative parameters of patients with visual acuity loss caused by pathological myopia were compared. Results The imaging causes of visual acuity loss in 97 cases of pathological myopia were MCNV, paint crack, MRS, macular atrophy, macular anterior membrane, macular full layer hole, macular lamellar hole and PIC respectively in the order of proportion from high to low. Accounted for 63.92%, 38.14%, 34.02%, 30.93%, 28.87%, 11.34%, 10.31% and 2.06%, respectively. Vision loss due to pathological myopia due to MCNV, paint crack, MRS, macular atrophy, anterior macular membrane, macular lamellar hole, The age of patients with full-thickness macular hole was(52.39±1.40) years,(53.10±1.41) years,(52.57±1.38) years,(53.45±1.45) years,(54.22±1.47) years,(52.87±1.42) years,(55.10±1.51) years, respectively. Were higher than those of PIC patients(31.07±1.03). MCNV, paint crack, macular atrophy, macular lamellar hole, The visual acuity of patients with full-thickness macular hole was(0.55±0.13) Log MAR,(0.51±0.12) Log MAR,(0.60±0.14) Log MAR,(0.63±0.15) Log MAR,(0.52±0.11) Log MAR, The visual acuity of MRS and MACular anterior membrane-patients was(0.30±0.10) Log MAR and(0.29±0.08) Log MAR, respectively, which was lower than(0.35±10) Log MAR of PIC patients(all P < 0.05). Conclusion The main cause of visual acuity loss caused by pathological myopia is macular structure abnormity, among which MCNV is the most common, which deserves clinical attention.