光学相干断层扫描观察38眼病理性近视中黄斑视网膜劈裂

目的 为了解病理性近视中黄斑劈裂的发生情况及其特征。方法 对2002年6月～2003年12月间光学相干断层扫描（Optic Coherence Tomography，OCT）确诊为黄斑部视网膜劈裂的病理性近视眼进行了进一步的检查．包括最佳校正视力、超声波了解后巩膜葡萄肿和眼轴。结果 OCT确诊有36名病理性近视患者的38眼中存在黄斑部的视网膜劈裂．所有眼都完成了进一步的检查。38眼都视力低下，超声波检查都发现了后巩膜葡萄肿，平均屈光度数-10．5D，平均眼轴为29．6mm。OCT中视网膜劈裂的形态和范围差异较大，但大致分为两种类型：外层劈裂和内层劈裂；外层劈裂较常见。内层劈裂通常与外层劈裂相伴，同时常位于黄斑的周边区域；两种形式的劈裂可分别也可共同存在；劈裂常伴有局限性的视网膜脱离和其他黄斑病变。结论 黄斑劈裂在临床病理性近视眼中并不罕见，且常与其他黄斑病变相伴，OCT在其诊断和观察中有着重要的意义。

Observation of macular schisis in 38 highly myopia eyes by optic coherence tomography

Purpose To improve our understanding of macular schisis in highly myopic eyes. Methods From 2002.1-2003.12, the highly myopic eyes(>6D) which had macular schisis found by optic coherence tomography(OCT) at our hospital were included in the study. Each of the 38 eyes then received further examinations like visual acuity, refractive error check and ultrasonic check. Then the results were analyzed to find the characteristic of the entity. Results During that period, OCT found macular schisis in 38 highly myopic eyes from 36 patients. Their vision was low, and their average axial length and refractive error were 29.6 mm and-10.5 D respectively. The appearance and the area of the schisis were different greatly among the eyes. But the schisis in the schisis group could be largely divided into two types: inner and outer schisis. They could exit independently or concurrently in the same eye. The outer schisis was more common, and the inner schisis was often accompanied by the outer one. The inner type was tending to locate at the periphery of the macular and the outer type was more centrally localized. The schisis was often accompanied by other macular findings, like retinal detachment, macular hole. Conclusions Macular schisis in highly myopic eyes is not uncommon in the clinic. OCT is useful in its diagnosis.