病理性近视眼视网膜脱离患者对侧眼黄斑形态和功能的观察

目的了解病理性近视眼视网膜脱离患者对侧眼黄斑的形态和功能。设计前瞻性、非对照研究。研究对象20例屈光度≥-6D、眼轴≥26mm、一眼孔源性视网膜脱离的病理性近视患者的对侧眼。方法对上述患者的对侧眼行显然验光、眼底检查、黄斑区相干光断层扫描(OCT)及神经上皮厚度分析、多焦视网膜电图检查(mERG),并对结果进行分析。主要指标眼轴、近视度数、眼底的临床体征、OCT及mERG检查结果。结果20眼平均眼轴29．64mm；平均近视度数-15．87D；眼底检查有1项病理性近视样改变的9眼,2项的4眼；OCT检查中17眼有不同程度的改变；mERG检查显示黄斑区P1波高峰峰尖消失的4眼,P1波高峰峰尖消失伴高峰明显降低者7眼,P1波高峰基本缺如者8眼；只有1例无视物模糊、变形主诉,同时OCT及mERG检查均正常。结论病理性近视视网膜脱离患者对侧眼往往有形态和功能上的改变,综合应用眼底检查、OCT扫描、mERG检查能较早发现病变。(眼科2006,15：341-344)

Observation on the macular character and function of the contralateral eyes of patients with pathologic myopia combined with retinal detachment

Objective To describe the clinical character and function of the maculae of the contralateral eyes of patients with pathologic myopia combined with retinal detachment.Design Prospective,noncomparative study.Participant 20 patients enrolled in the study are according with the following criteria:1)the lens power of each eye is equal to or greater than -6D;2)the ocular axis of each eye is equal to or longer than 26mm;3)there is one eye diagnosed as retinal detachment combined with pathologic myopia.Method Objective optometry,fundus examination,OCT scan for the macular area,measurement of the thickness of the retinal neuroepithelial lay- er,and mERG were carded out for each patient.The reports were collected for further analysis.Main Outcome Measure Axis length, diopter,fundus,OCT and mERG.Result The mean ocular axis of the 20 eyes was 29.64mm.The mean of their lens power was -15.87D. Among the 20 eyes,there were 9 eyes with one positive signs of pathologic myopia,and 4 eyes with two positive sign of pathologic my- opia.The OCT scan revealed various abnormities in 17 eyes.The mERG examination findings showed apex of P1 wave disappeared in 4 eyes,wave amplitude decreased combined with the apex of P1 wave disappeared in 7 eyes,and the whole wave crest of P1 wave disap- peared in 8 eyes.There was only one patient presented with main complain of blurting vision and distortion but with no abnormality in OCT and mERG examination.Conclusion The abnormalities of both the clinical character and function of macula are often presented in the contralateral eye of pathologic myopia patients with retinal detachment in one eye.The OCT scan and mERG examination have dis- tinct advantage in estimating the configuration and function of the macula of pathologic myopia patient.The combination of fundus ex- amination,OCT scan and mERG may contribute to the earlier finding of the macular abnormality.(Ophthalmol CHN,2006,15:341-344)