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目的探讨光学相干断层成像技术在高度近视眼黄斑部视网膜劈裂中的应用价值。方法 22例34眼高度近视患者(屈光度从-10.00D 至-23.00D,平均-16.15D)行眼部超声波和 OCT 检查。对于黄斑部视网膜劈裂的患者追踪观察12月以上。结果全部病例 B 超均显示后巩膜葡萄肿,A 超测眼轴长28.60mm 32.95mm(平均30.45mm)。16眼出现黄斑部局限性视网膜浆液性脱离,其中14眼伴视网膜劈裂。结论高度近视眼后巩膜葡萄肿伴有黄斑部视网膜劈裂者并不罕见,OCT 能很好地显示其特征。大多数患者视力和视网膜劈裂稳定,但当黄斑部视网膜劈裂合并玻璃体牵拉并存时,则有继发黄斑裂孔的危险,可进行玻璃体切割手术。高度近视眼黄斑部视网膜劈裂(Retinoschisis,R.S)是光学相干涉断层成像技术(Optical CoherenceTomography,OCT)新近描述的一种视网膜病变。过去这类视网膜病变于生物显微镜下难于发现,且可被误诊为扁平视网膜脱离和黄斑水肿。OCT 这一新的医学影像技术可显示活体视网膜的横切面解剖结构,并可准确观察视网膜结构改变,清晰地显示玻璃体一视网膜牵拉关系。本研究对2001～2004年在我院门诊就诊或住院确诊为病理性高度近视的患者22例34眼进行 OCT 检查,并对7例14眼黄斑部视网膜劈裂与浆液性脱离患者进行追踪观察,结果如下。
Objective To investigate the value of optical coherence tomography in the treatment of macular retinal rupture in high myopia. Methods Twenty-two eyes of 34 patients with high myopia (diopter from -10.00D to -23.00D, mean-16.15D) underwent ocular ultrasound and OCT. Patients with macular debridement were followed for more than 12 months. Results All cases showed posterior staphyloma with B-mode ultrasound. The axial length of A-test was 28.60mm 32.95mm (average 30.45mm). 16 eyes showed partial retinal serous detachment, of which 14 eyes with retinal detachment. Conclusion It is not uncommon for posterior staphyloma with macular retinal rupture in high myopia. OCT can show its characteristics well. Most patients with visual acuity and retinal splitting stable, but when macular retinal splitting with vitreous traction co-exist, there is the risk of secondary macular hole, vitrectomy. Retinoschisis (R.S) is a newly described retinopathy of Optical Coherence Tomography (OCT). In the past this type of retinopathy was difficult to detect under a biological microscope and could be misdiagnosed as flat retinal detachment and macular edema. OCT, a new medical imaging technology that can display the cross-sectional anatomy of living retina and accurately observe changes in the structure of the retina, clearly shows the vitreoretinal-retinal traction relationship. In this study, OCT was performed in 22 patients (34 eyes) diagnosed as pathological high myopia in outpatient clinics in our hospital from 2001 to 2004. Seven patients (14 eyes) with macular retinal rupture and serous detachment were followed up, The result is as follows.