CAJ | 학술논문

视网膜裂孔是主要致盲性眼病原发性视网膜脱离的原因,封闭裂孔是其治疗原则.尽管手术疗法已能使现今大多数视网膜脱离成功复位,但视网膜裂孔发生的原因、能否预防视网膜脱离的发生以及怎样才能获得视网膜复位后满意的视力恢复等基本问题,仍然困扰原发性视网膜脱离的防治.近年研究提示,视网膜裂孔的形成与玻璃体液化、后玻璃体脱离过程中异常的玻璃体视网膜附着牵拉有关.完全性后玻璃体脱离可在玻璃体基底部后缘形成裂孔,而部分性后玻璃体脱离则可引起后部裂孔,尤其是表现为视网膜外层缝隙样增厚(中心凹劈裂)和玻璃体黄斑牵拉等特征性的近视牵拉性黄斑病变.已知黄斑的微结构改变、视网膜萎缩、前膜形成等是视网膜复位后视力不良的原因.因此,应加深对玻璃体病变和牵拉机制的认识,探索其临床评估与防治途径,促进视网膜复位后的视力恢复,将原发性视网膜脱离的防治提高到新的水平.
시망막렬공시주요치맹성안병원발성시망막탈리적원인,봉폐렬공시기치료원칙.진관수술요법이능사현금대다수시망막탈리성공복위,단시망막렬공발생적원인、능부예방시망막탈리적발생이급즘양재능획득시망막복위후만의적시력회복등기본문제,잉연곤우원발성시망막탈리적방치.근년연구제시,시망막렬공적형성여파리체액화、후파리체탈리과정중이상적파리체시망막부착견랍유관.완전성후파리체탈리가재파리체기저부후연형성렬공,이부분성후파리체탈리칙가인기후부렬공,우기시표현위시망막외층봉극양증후(중심요벽렬)화파리체황반견랍등특정성적근시견랍성황반병변.이지황반적미결구개변、시망막위축、전막형성등시시망막복위후시력불량적원인.인차,응가심대파리체병변화견랍궤제적인식,탐색기림상평고여방치도경,촉진시망막복위후적시력회복,장원발성시망막탈리적방치제고도신적수평.
Retinal break is the cause of primary retinal detachment,which remains a main cause for visual loss,and closure of the breaks is the principle of treatment.Currently surgical treatment can successfully reattach the retina in most cases.However,some basic questions still beset treatment of the disease,such as the cause responsible for development of retinal breaks and how to prevent it,and how the visual recovery can be satisfactory after reattachment surgery.Recent research indicates that the development of retinal breaks is associated with the process of vitreous liquefaction,posterior vitreous detachment (PVD) and abnormal vitreoretinal adhesion and traction.The retinal breaks can occur in the posterior margin of the vitreous base in the eye with complete PVD.Partial PVD may cause posterior breaks especially in cases of myopic traction maculopathy associated with schisis-like thickening in the outer retina (foveoschisis) and vitreomacular traction.It is known that microstructural changes and atrophy of the macula,and epiretinal membrane formation are the reasons for poor vision after the retina is reattached.Therefore,more attention should be paid to further understand the vitreous pathology and traction mechanism,to research for methods of its clinical evaluation and strategy of prevention and treatment,and to accelerate visual recovery after reattachment surgery,in order to raise the standard of the disease treatment.