CAJ | 학술논문

目的：应用频域相干光断层扫描仪（ OCT）观察伴有后巩膜葡萄肿的高度近视眼后极部视网膜劈裂的特征，并分析其发生的原因。方法非干预性的临床病例回顾性研究。对所观察患者126例﹙212只眼﹚进行了裂隙灯、眼底、OCT以及A、B型超声等检查，对其中发生视网膜劈裂的进行OCT图像分析。结果126例﹙212只眼﹚中22例﹙37只眼﹚发生后极部视网膜劈裂，并伴有眼底改变。视网膜劈裂发生部位都与后巩膜葡萄肿位置相应。37只眼视网膜劈裂均有外层劈裂，合并内层和（或）中层劈裂26只眼。29只眼可见玻璃体牵引视网膜征象，其中22只眼玻璃体后界膜的附着点与视网膜劈裂或并发视网膜脱离的最高点相应。4只眼合并黄斑裂孔，其中全层与板层裂孔各半。未发生视网膜劈裂的175只眼的黄斑视网膜厚度与眼轴长呈负相关。结论高度近视眼伴后巩膜葡萄肿的玻璃体、内界膜的牵引力，后极部巩膜葡萄肿的拉伸力在视网膜劈裂中发生作用，脉络膜的萎缩削弱了视网膜各层间的紧密性，使视网膜劈裂更易发生。定期OCT监测有助于视网膜劈裂和（或）脱离的早期发现与明确诊断。
목적：응용빈역상간광단층소묘의（ OCT）관찰반유후공막포도종적고도근시안후겁부시망막벽렬적특정，병분석기발생적원인。방법비간예성적림상병례회고성연구。대소관찰환자126례﹙212지안﹚진행료렬극등、안저、OCT이급A、B형초성등검사，대기중발생시망막벽렬적진행OCT도상분석。결과126례﹙212지안﹚중22례﹙37지안﹚발생후겁부시망막벽렬，병반유안저개변。시망막벽렬발생부위도여후공막포도종위치상응。37지안시망막벽렬균유외층벽렬，합병내층화（혹）중층벽렬26지안。29지안가견파리체견인시망막정상，기중22지안파리체후계막적부착점여시망막벽렬혹병발시망막탈리적최고점상응。4지안합병황반렬공，기중전층여판층렬공각반。미발생시망막벽렬적175지안적황반시망막후도여안축장정부상관。결론고도근시안반후공막포도종적파리체、내계막적견인력，후겁부공막포도종적랍신력재시망막벽렬중발생작용，맥락막적위축삭약료시망막각층간적긴밀성，사시망막벽렬경역발생。정기OCT감측유조우시망막벽렬화（혹）탈리적조기발현여명학진단。
Objective The objective is to use optical coherence tomography ( OCT) to observe the features of the retinoschisis in the fundus posterior pole of high myopia with posterior staphyloma, and to analyze the reasons to causthe disease.Methods The research is in the way of non-intervene and observation.212 eyes for more than 6.00D in 126 ca-ses were checked with type-B ultrasonic to find the patients who have posterior staphyloma.Further checks were made to them with split lamp, fundus check, mydriasis funduscopy check, Type-A ultrasonic check and OCT check.Then the OCT imagine with retinoschisises are analyzed.Results 37 eyes among the 212 eyes were found the the retinoschisis in fundus posterior pole of high myopia with posterior staphyloma.The location of the retinoschisis is corresponding to the location of the posterior staphyloma.Among the 37 eyes 26 eyes have single or interior and/or middle-level retinoschisis.29 eyes of the 37 eyes have the phenomenon of having vitreous body pull the retinas, including 22 eyes to have the location of the pos-terior hyaloids membrane be corresponding to the highest points of the retinoschisis or retinal detachment.Four eyes have macular holes and two eyes of them have full-thickness ceasma holes and two have pseudo-macular holes.The 175 eyes which have no retinoschisis shows that the thickness of their macular epiretinal membrance is negative corresponding to the eye axial lengths.Conclusion The retinoschisis has relationship with the vitreous body of the fundus posterior pole of high myopia with posterior staphyloma, pulling force of the internal limiting membrane and the stretching of the posterior staphy-loma.The shrinking of the choroid membrances for the high myopia weakens the closeness of the layers of the retinas to make the retinas be easy to form retinoschisis.The hight myopia people should have a regular check with OCT to have the former check and diagnosis of retinoschisis and/or retinal detachment.