泡状视网膜脱离临床特征及病因学分析

目的 观察泡状视网膜脱离患者的临床特征及进行病因学分析.方法 回顾性分析2003至2008年在广州中山眼科中心住院治疗的表现为泡状视网膜脱离的患者22例(35只眼),其中诊断为弥漫性视网膜色素上皮病变9例,诊断为大泡状视网膜脱离或渗出(浆液)性视网膜脱离的病人13例.患者均经眼底检查及眼底荧光素血管造影,部分患者同时进行吲哚青绿血管造影确诊.结果 22例患者中,男性15例(68%),女性7例(32%);单眼病变9例(41%),双眼病变13例(59%);首诊年龄25～64岁,(平均年龄42岁).4例(18%)患者全身应用过糖皮质激素,其中2例(10%),为发病前使用,1例(5%)由于应用激素治疗,视网膜脱离范围增加.1例(5%)由于应用糖皮质激素治疗患眼,而诱发健眼渗出性视网膜脱离.多灶性泡状视网膜脱离9例,主要诊断为弥漫性视网膜色素上皮病变,部分预后较好,部分发展为大泡状视网膜脱离;大泡状视网膜脱离13例,预后不良.结论 泡状视网膜脱离常发生于中年男性,大多为双眼发病.其发生和发展与视网膜色素上皮异常及脉络膜血管通透性增加有关,精神压力和全身应用糖皮质激素可能诱发和加重病情,早期应积极药物及激光治疗,晚期手术治疗可挽救部分有用视力.

Abstract：

Objective To observe the clinical manifestations of bullous retinal detachment and analyze the etiological factors.Methods A retrospective analysis of the clinical data was conducted in 22 patients with multifocal retinal pigment epitheliopathy (DRPE) and big bullous retinal detachment (BBRD), who were admitted between 2003 and 2008 in Zhongshan Ophthalmic Center with the diagnoses established by ocular fundus examination, fundus fluorescein angiography (FFA) and/or indocyanine green angiography (ICGA). Results The patients included 15 men (68%) and 7 women (32%), with a mean age at the initial visit of 42 years, ranging from 25 to 64 years. Four patients (18%) received previously systemic corticosteroid therapy, and 2 of them used corticosteroids before retina detachment, 1 suffered progression of retinal detachment after corticosteroid therapy, and the other developed retinal detachment in the healthy eye during the therapy. Multifocal bullous retinal detachment was diagnosed as diffuse pigment epitheliopathy (DRPE) in 9 cases. Most of the 13 cases of big bullous retinal detachment had poor vision after operation and laser therapy. Conclusion Bullous retinal detachment occurs most frequently in mid-life and more often in men than women. Abnormal retinal pigment epithelium (RPE) and hyperpermeability of the choroid vessels are associated with its occurrence. Systemic corticosteroid therapy and mental stress may induce and aggravate this disease. Early medication and laser therapy are effective, arid surgical intervention may save only part of the vision in advanced cases.

Clinical characteristics and etiological analysis of bullous retinal detachment

Objective To observe the clinical manifestations of bullous retinal detachment and analyze the etiological factors. Methods A retrospective analysis of the clinical data was conducted in 22 patients with multifocal retinal pigment epitheliopathy (DRPE) and big bullous retinal detachment (BBRD), who were admitted between 2003 and 2008 in Zhongshan Ophthalmic Center with the diagnoses established by ocular fundus examination, fundus fluorescein angiography (FFA) and/or indocyanine green angiography (ICGA). Re...