高度近视眼视力矫正不良与屈光度及眼底蜕变的关系

目的探讨高度近视眼的视力矫正不良随屈光度增加及眼底退行性病理变化(蜕变)的进展致视功能严重受损,视力愈难矫正的关系。方法高度近视眼患者140例(280眼),其屈光度在-6.25～-30.00D之间,全数进行散瞳视网膜检影验光;用A,B超测量眼球前后内径轴长;作眼底FFA检查,统计处理。结果高度近视眼视力矫正不良随屈光度增加而明显下降,当-15.00D时临床视力平均矫正不足0.42,当-25.00D时视力平均矫正在0.25,有极显著差异性(P<0.001)。根据FFA检查眼底后极部病变,随受损广泛程度不同而出现:单纯性病变,弥漫性病变,斑块性病变,复合性病变4种类型。同时有多种并发症发生而严重影响视力矫正,有明显差异性(P<0.01)。结论高度近视眼的视力矫正(光学)随屈光度增加而明显下降,屈光度愈高视力越难达到理想矫正;眼底后极部的一系列病理改变(蜕变)越广泛受损越严重则影响视功能愈明显,视力矫正愈降低;应采取综合性治疗措施。

Influence of diopter and fundal degeneration on vision correction in high myopia

Aim To study the influence of diopter and fundal changes on vision co rrection in high myopia. Methods A total of 280 high myopic eyes of 140 patient s (-6.25--30.00 D) were examined with mydriatic coroscopic optometry, ultrasoni c A and B examinations as well as FFA. The data were processed statistically. R esults In high myopia, the higher the diopter, the less satisfactory the correc tion of visual acuity. At-15.00D, vision was improved by 0.42 on average; at-2 5.00D, vision was improved by 0.25 on average. The difference was significant (P <0.001). FFA revealed that 4 types of damage in the posterior polar section, in cluding simple, diffused, macular and complex changes, which caused several comp lications and badly affected vision correction. Conclusion In high myopia, the capacity of clinical vision correction is negatively related with diopter. Damag e in the posterior polar section affects visual acuity and its correction. In hi gh myopia, visual acuity can only be corrected with combination of optical lens and other general treatment.