近视眼与视网膜退行性病变

目的探讨近视眼眼底的视网膜退行性病变的分布规律。方法选择近视眼患者503例984只眼，充分散瞳后验光，并依近视程度分为三组，即Ⅰ组：近视屈光度〈-3．00DS；Ⅱ组：近视屈光度-3．00DS～-6．00DS：Ⅲ组：近视屈光度〉-6．00DS。用间接检眼镜和裂隙灯联合三面镜或全视网膜镜详细检查眼底，记录周边部视网膜变性数量、特点和位置，并进行统计分析。结果984只眼的屈光状态为（-6．56±5．70）DS，周边部视网膜变性155只眼，百分率为15．75％，其中单眼19例（10．98％）；双眼73例（89．02％），周边部视网膜变性百分率：Ⅰ组为17．42％；Ⅱ组为33．54％；Ⅲ组为49．04％。双眼的变性区分布有对称性，百分率为60．65％。变性区多位于颞侧象限，颞上或颞下象限无明显差异。变性区以不压变白和树枝样变性多见，其次为格子样变性和单纯视网膜裂孔。结论高度近视眼周边部视网膜变性发生率高，不同屈光度组的周边视网膜变性的构成比存在显著差异，且随近视屈光度的增加而增高，且有对称性，这些特征对高度近视眼的诊断、治疗和预后具有指导意义。

Characteristics and distributed rules of peripheral retinal degeneration in the eye with high myopia

Objective：To discuss characteristics and distributed rules of peripheral retinal degeneration in the eye with high myopia. Methods： Nine hundred and eighty four eyes of 503 cases with myopia were examined. They were divided into 3 groups ： group 1 of diopter of myopia 〈 -3.00DS ; group 2 of diopter of myopia from -3.00DS to -6.00DS and group 3 of diopter of myopia 〉 -6.00DS . The methods of examination included in noncycloplegic and cycloplegic refraction, and direct ophthalmoscope and slit-tamp microscopy combined with three-mirror contact tens or panretinoscope. Quantity, characteristics and distributed rules of peripheral retinal degeneration were recorded and analyzed. Results. The mean refraction degree of 984 eyes was （ -6.56 ±5.70） DS. Of 984 eyes, 155 eyes had peripheral retinal degeneration （ 15.75% ）, with 19 cases of the changes in unbilateral eye was （ 10.98% ） and 73 cases in bilateral eyes （ 89.02% ） . Incidence rates of peripheral retinal degenerations were 17.42% , 33.54% and 49.04% in three groups respectively. There was a symmetry in distribution of peripheral retinal degeneration in bilateral eyes of 47 cases （60.65 % ）. Most of the lesions were found in the peripheral retina of temporal quadrants, and the prevalence of lesions in both superior and inferior quadrants was nearly similar. The most common peripheral retinal lesions were white without pressure and branch degeneration, which were followed by lattice degeneration and retinal hole. Conclusion： There is a high prevalence of peripheral retinal degenerations in the eye with high myopia, and a symmetry in bilateral eyes. There is significant difference in relevance ratio for peripheral retinal degenerations among the different diopter groups, and the ratio increases with the increase of myopia diopter. So the features are valuable in diagnosis, treatment and prognosis of high myopia.