高度近视黄斑出血相关因素分析

The analysis of correlative factors of macular hemorrhage in high myopia

目的对高度近视黄斑出血的相关因素进行分析。方法对55例(69眼)高度近视黄斑出血的患者进行视力、屈光度、A/B超、眼底彩色照相及荧光素眼底血管造影(fundusfluoresceinangiography,FFA)检查。结果43例(78.2%)近视病程超过20年,54眼(78.3%)眼轴超过29mm,44眼(63.8%)出现后巩膜葡萄肿,所有患者屈光度均超过-10D,黄斑出血时8眼(11.6%)可见漆样裂纹,6眼(8.7%)显示视网膜下新生血管(subretinalneovaseularization,SRNV)。出血吸收后19眼(27.5%)可见漆样裂纹,9眼(13.0%)出现SRNV。结论近视病程超过20年、眼轴超过29mm、屈光度超过-10D、有后巩膜葡萄肿的患者容易发生黄斑出血,漆样裂纹与高度近视黄斑出血有密切的关系。高度近视黄斑出血分为两种类型:一种是不伴SRNV的单纯型出血,另一种是伴有SRNV的出血。单纯型黄斑出血预后较好,伴有SRNV的黄斑出血预后差,定期检查眼底及FFA,有助于早期发现SRNV。

Objective To investigate the correlative factors of macular hemo rr hage in high myopia. Method Visual acuides,refractive degrees,A/B ultrasonic s can,color photography and fundus fluorescein angiography (FFA) were performed on 55 patients (69 eyes) of high myopia with macular hemorrhage. Results The cours e of disease overruned 20 years in 43 cases (78.2%). The axial length of 54 eye s(78.3%) was longer than 29mm. Posterior scleral staphyloma was found in 44 eye s (63.8%). The refractive degrees of all patients overruned-10D. The lacquer crack was found in 8 eyes (11.6%) with macular hemorrhage. The subretinal neova scularization (SRNV) was revealed in 6 eyes (8.7%). After absorption of hemorrh age,the lacquer crack was found in 19 eyes (27.5%) and the subretinal neovascu larization (SRNV) was revealed in 9 eyes (13.0%). Conclusions Macular hemorrhag e could be found in those patients whose course of disease overruned 20 years,t he axial length was longer than 29mm, the refrative degrees overruned-10D and those patients with posterior scleral staphyloma. Lacquer crack has a correlativ e relation with macular hemorrhage of high myopia. Macular hemorrhage of high my opia were divided into the simple type and the subretinal neovascular type. The simple type has a good prognosis and the another type has a bad prognosis. Regul ar examination of fundus and FFA is helpful to find out the SRNV early.