OCT在病理性近视黄斑视网膜劈裂诊断中的应用

目的 探讨病理性近视黄斑视网膜劈裂的光学相干扫描（OCT）视网膜形态特征.方法 回顾分析经OCT检查存在黄斑视网膜劈裂的21例病理性近视患者32眼（劈裂组）的OCT图像特点,并与病理性近视非劈裂组（51例73眼）的屈光度、眼轴长度及中心凹局限性视网膜脱离、黄斑裂孔、黄斑前膜、后巩膜葡萄肿、玻璃体后脱离发生率进行比较.结果 劈裂组外层劈裂25眼（78.12％）,中层劈裂5眼（15.63％）,内层劈裂4眼（12.50％）,存在2层及以上的多层黄斑视网膜劈裂7眼（21.88％）.2组屈光度、眼轴长度、中心凹局限性视网膜脱离、黄斑裂孔、黄斑前膜、玻璃体后脱离发生率差异均无统计学意义（P＞0.05）;劈裂组后巩膜葡萄肿发生率明显高于非劈裂组（96.88％ vs.64.38％,P＜0.01）.结论 病理性近视黄斑视网膜劈裂可表现为多种形态;常伴发其他黄斑病变;OCT能清晰地显示病理性近视黄斑视网膜劈裂的形态特征,有助于黄斑视网膜劈裂的诊断.

Application of optical coherence tomogtaphy in the diagnosis of retinoschisis in pathologic myopia

Objective To investigate the characteristics of optical coherence tomogtaphy （OCT） image in pathologic myopia. Methods The OCT characteristics in 21 patients （32 eyes ） with pathologic myopia who were diagnosed with macular retinoschisis （ retinoschisis group） by OCT observation were retrospectively analyzed. The clinico - pathological data （ diopter, ocular axial length and rate of macular retinal detachment, macular hole, macular epiretinal menbrane, posterior scleral staphyloma, and posterior vitreous detachment） between retinoschisis group and non -retinoschisis group （pathologic myopia without macular retinoschisis, 51 cases 73 eyes ） were compared. Results In the retinoschisis group, outer sehisis （25 eyes, 78.12% ） , middle schisis （5 eyes, 15.63% ） , inner schisis （4 eyes, 12.50% ） were observed. Macular retinoschisis with 2 or more layers was found in 7 eyes （21.88%）. The diopter, ocular axial length and the rate of macular retinal detachment, macular hole, macular epiretinal menbrane, and posterior vitreous detach- ment showed no statistically significant difference between the two groups （P 〉 0.05 ）. The rate of posterior scleral staph- yloma was much higher in the retinoschisis group than in the non -retinoschisis group （96.88% vs. 64.38%, P 〈 0.01 ）. Conclusions The macular retinoschisis in pathologic myopia can be manifested in various forms and is often ac- companied by other macular pathological findings. OCT can display the morphological characteristics of macular retinos- chisis clearly and is useful in the diagnosis of macular retinoschisis.