CAJ | 학술논문

近视牵引性黄斑病变是一组与高度近视相关的眼底病变,可严重影响患者视功能.目前多认为其发病机制为多种牵引因素导致的黄斑部视网膜结构和功能紊乱,包括后玻璃体脱离、后玻璃体皮质残留和黄斑前膜等作用于视网膜内层的牵引力,后巩膜葡萄肿等作用于视网膜外层的牵引力,以及视网膜自身因素的影响如视网膜内界膜、视网膜小动脉的改变等.近视牵引性黄斑病变的治疗以手术为主,如玻璃体切除术和巩膜加固术,目的在于解除视网膜牵引和恢复视功能,而目前争论则多集中于术式的选择.本文主要就此类疾病的发病机制和治疗策略进行综述和讨论.
근시견인성황반병변시일조여고도근시상관적안저병변,가엄중영향환자시공능.목전다인위기발병궤제위다충견인인소도치적황반부시망막결구화공능문란,포괄후파리체탈리、후파리체피질잔류화황반전막등작용우시망막내층적견인력,후공막포도종등작용우시망막외층적견인력,이급시망막자신인소적영향여시망막내계막、시망막소동맥적개변등.근시견인성황반병변적치료이수술위주,여파리체절제술화공막가고술,목적재우해제시망막견인화회복시공능,이목전쟁론칙다집중우술식적선택.본문주요취차류질병적발병궤제화치료책략진행종술화토론.
Myopic traction maculopathy is a group of ocular fundus diseases related to high myopia,which can severely impact on patients' visual function.It is well recognized that the abnormal of macular structure and function in the disease are resulted from various traction mechanisms,including the forces from posterior vitreous detachment,posterior vitreous cortex,and macular epiretinal membrane which acting on the inner retina,the force from posterior staphyloma which acting on the outer retina,and retinal intrinsic features such as the changes of inner limiting membrane and arterioles.The treatments are mainly based on surgery,including vitrectomy and scleral reinforcement surgery in order to relieve the retinal traction.The options of specific surgery procedures are still under debated.In this article,we reviewed the pathogenic mechanisms and therapeutic strategies of myopic traction maculopathy.