CAJ | 학술논문

目的观察高度近视眼黄斑劈裂的OCT形态学特征,分析其发生的相关危险因素.方法回顾性分析268例(369只眼)屈光度≥-6.00D的高度近视眼患者继发视网膜劈裂的OCT表现以及与眼轴长度、屈光度、后巩膜葡萄肿、后极部脉络膜视网膜萎缩变性等因素的相互关系.结果 OCT显示68例(93只眼)存在视网膜劈裂;其中78只眼为外层劈裂,14只眼为混合性劈裂,1眼为内层劈裂.所有存在劈裂眼中,2只眼劈裂远离黄斑区,91只眼位于黄斑区,累及一至四个象限不等,其中53只眼为中央凹劈裂,38只眼为旁中央凹劈裂,中央凹劈裂的形态多样,并伴有视网膜前膜或玻璃体牵引、局限性视网膜脱离、黄斑板层裂孔等改变.所有高度近视眼患者中,视网膜劈裂眼与未发生视网膜劈裂眼的眼轴长度、屈光度、后巩膜葡萄肿、玻璃体牵引或视网膜前膜以及后极部脉络膜视网膜萎缩变性比较,差异均有统计学意义(P均<0.01),Logistic回归结果示:超长眼轴(≥29mm)是视网膜劈裂发生的危险因素,屈光度并不是其发生的危险因素,后巩膜葡萄肿、玻璃体牵引或视网膜前膜以及后极部脉络膜视网膜萎缩变性均是其发生的危险因素(P=0.002,0.073,0.027,0.003,0.011).结论 OCT能明确视网膜劈裂发生的部位,清晰地显示视网膜劈裂的形态特征,视网膜劈裂多发生在黄斑中央凹.可累及整个黄斑区,以外层劈裂多见.视网膜劈裂的发生与超长眼轴、后巩膜葡萄肿、玻璃体视网膜牵引以及后极部脉络膜视网膜萎缩变性等因素有关.
목적 관찰고도근시안황반벽렬적OCT형태학특정,분석기발생적상관위험인소.방법 회고성분석268례(369지안)굴광도≥-6.00D적고도근시안환자계발시망막벽렬적OCT표현이급여안축장도、굴광도、후공막포도종、후겁부맥락막시망막위축변성등인소적상호관계.결과 OCT현시68례(93지안)존재시망막벽렬;기중78지안위외층벽렬,14지안위혼합성벽렬,1안위내층벽렬.소유존재벽렬안중,2지안벽렬원리황반구,91지안위우황반구,루급일지사개상한불등,기중53지안위중앙요벽렬,38지안위방중앙요벽렬,중앙요벽렬적형태다양,병반유시망막전막혹파리체견인、국한성시망막탈리、황반판층렬공등개변.소유고도근시안환자중,시망막벽렬안여미발생시망막벽렬안적안축장도、굴광도、후공막포도종、파리체견인혹시망막전막이급후겁부맥락막시망막위축변성비교,차이균유통계학의의(P균<0.01),Logistic회귀결과시:초장안축(≥29mm)시시망막벽렬발생적위험인소,굴광도병불시기발생적위험인소,후공막포도종、파리체견인혹시망막전막이급후겁부맥락막시망막위축변성균시기발생적위험인소(P=0.002,0.073,0.027,0.003,0.011).결론 OCT능명학시망막벽렬발생적부위,청석지현시시망막벽렬적형태특정,시망막벽렬다발생재황반중앙요.가루급정개황반구,이외층벽렬다견.시망막벽렬적발생여초장안축、후공막포도종、파리체시망막견인이급후겁부맥락막시망막위축변성등인소유관.
Objective To improve our understanding of the morphological characteristics of macular retinoschisis in highly myopic eyes by optical coherence tomography and to discuss the probably associated factors of it. Methods In the retrospective study, 268 patients(369 eyes)with high myopia(spherical equivalent 3≥-6.00D)were included, from which a diagnosis of retinoschisis was given by optical coherence tomography, and observed the area and morphological characteristics of the retinoschisis. The factors that were associated with the occurrence and the development of the retinoschisis were investigated. Results OCT showed that 68 patients(93 eyes)had retinoschisis. Outer schisis was present in 78 eyes, mixed schisis in 14 eyes and inner schisis in 1 eye. The retinoschisis in 2 eyes located far from the macular area, and the other 91 eyes located in the macular area, which were involved into one to four quadrants, in which foveoschisis were present in 53 eyes, and parafoveoschisis in 38 eyes. There were several kinds of types in foveoschisis, companied with other pathological changes, such as vitreoretinal traction, preretinal membrane, foveal detachment and lamellar holes.We proceeded the comparison of the axial length, spherical equivalent, posterior staphyloma, vitreoretinal interface factors and posterior polar chorioretinal atrophy in retinoschisis and non-retinoschisis in highly myopic eyes, finding that all the differences were significant(P <0.01), but Logistic regression showed that all the factors above were the risk factors associated with the retinoschisis(P =0.002, 0.027, 0.003, 0.011)except the spherical equivalent(P =0.073). Conclusions OCT can display the area and morphological characteristics of retinoschisis clearly, the retinoschisis is mostly present in the fovea, which is usually involved into the whole macular area, and the outer schisis is common. The occurrence and development of the retinoschisis is associated with the axial length, posterior staphyloma, vitreoretinal interface factors and posterior polar chorioretinal atrophy.