摘要
目的:探讨高度近视眼引起的视力矫正不良在临床上随屈光度增加及眼底退行性病变(蜕变)的进展致视功能严重受损,视力愈难矫正的关系。 方法:对高度近视眼(屈光度在-6.25～-30.00)140例(280只眼)患者,全部进行散瞳视网膜检影验光;用AB超声波仪测量眼球前后内径轴长,并行眼底荧光血管造影(FFA)检查,最后进行统计学处理。 结果:高度近视眼视力矫正不良随屈光度增加而明显下降、当视力在20.00D时,临床上平均只能矫正不足0.42;当视力-25.00D时平均只能矫正在0.25,差异有极显著性意义(P<0.001);根据FFA检查眼底后极部病变,随受损广泛程度不同而出现:单纯性病变、弥漫性病变、斑块性病变以及复合性病变四种类型。同时并发多种合并症而严重影响视力矫正,差异有显著性意义(P<0.01)。 结论:高度近视眼在临床上的视力矫正(光学)随屈光度增加而明显下降、屈光度愈高视力越难达到理想矫正。眼底后极部的一系列病理改变(蜕变)越广泛、受损程度越严重,对视功能影响愈明显,视力愈难矫正。本文揭示高度近视眼已超出一般屈光不正范畴,应说它是一种综合性眼病,不仅要用光学镜片矫正,而且应采取综合性治疗措施。眼科学报 2003;19:211-215。
Purpose: To investigate the relations of the faulty vision correction caused by high myopia with the increase of diopters and progress of fundus retrograde affection.
Methods: One hundred and forty eases (280 eyes, diopters are -6.25—30.00) were examined with retinoseopy after undergoing mydriasis. Then the axial length of the anterioposterior diameters was measured with A-wave and B-wave ultrasonography. The fluoreseein fundus angiography (FFA) was performed on these eyes. The data were statistically analyzed.
Results: The faulty vision correction of high myopic eyes was obviously decreased with the increase of the diopters. When the visual acuity was -20.00 D, the average correction was clinically lower than 0.42 D. And it could only reach 0.25 D, with the vision being -25.00 D. The difference is very significant (P<0.001). FFA showed that the pathologic changes of fundus posterior pole appeared with the different degrees of damages, such as simple lesion, diffuse lesion, psoriasis lesion and complex lesion. And the vision correction could be simultaneously influenced by multiple complications. The difference is of significance (P<0.01).
Conclusion: Vision correction in high myopic eyes is obviously decreased with the increase of diopers. The higher the diopter is, the harder the vision can be ideally corrected. The greater the pathologic change at the fundus posterior pole, the severer the degree of the damage. The more obvious the visual function is influenced, the harder the vision can be corrected. This paper revealed that high myopia is a kind of complex eye disease. It can be treated not only by lens correction but also by other combined treatments. Eye Science 2003; 19: 211-215.
