真性小眼球葡萄膜渗漏综合征的诊断和治疗

Diagnosis and Treatment of Nanophthalmic Uveal Effusion Syndrome

目的:探讨真性小眼球葡萄膜渗漏综合征的诊断和治疗。方法:回顾性分析自2012年9月至2017年10月在武汉大学人民医院眼科中心就诊的6例6眼患者资料,经病史采集、专科检查诊断为真性小眼球葡萄膜渗漏综合征后,予以鼻下、颞下方板层巩膜切除术联合全层巩膜切除术,对术中切除的巩膜组织进行病检。结果:6例(6眼)患者中均可见周边部睫状体脉络膜分离及视网膜脱离。A超检查提示6眼眼轴短,长度为(16.94±0.76)mm。2眼在裂隙灯下可见表层巩膜静脉扩张。UBM检查示6眼周边部睫状体脉络膜分离。术中切除的巩膜组织病检可见巩膜纤维束排列紊乱。术后1月随访中5眼视力较术前提高,1眼视力稳定,6眼眼底检查可见视网膜复位。结论:板层巩膜切除术联合全层巩膜切除术是治疗真性小眼球葡萄膜渗漏综合征的有效手术方法。

Objective:To explore the diagnosis and treatment of nanophthalmic uveal effusion syndrome.Methods:A clinical retrospective study of six nanophthalmic uveal effusion syndrome cases(six eyes)diagnosed by slit lamp,indirect ophthalmoscope,A-scan,B-scan,ultrasound biomicroscopy and fundus fluorescein angiography in our hospital eye center was performel since September 2012 to October 2017.Then all eyes were conducted by lamina sclerectomy combined with sclerectomy and excised sclera performed biosy.Results:All patients’ funduscopic examination revealed peripheral ciliochoroidal detachment and retinal detachment.Six eyes had short axial lengths(16.94±0.76)mm by A-scan.Shallow sclerotic venectasia was found in 2 eyes.UBM examination showed peripheral ciliochoroidal detachment in all eyes.Histopathologically the sclerotic fiber bundle distributed at random and loose.Within a month post operation,visual acuity was improved in five eyes while only one case showed no change,and retinal reattached in all eyes.Conclusion:Lamina sclerectomy combined with sclerectomy is an effective method for nanophthalmic uveal effusion syndrome.