高度近视黄斑裂孔性视网膜脱离合并脉络膜脱离的相关因素分析

目的 探讨高度近视黄斑裂孔性视网膜脱离合并脉络膜脱离的相关危险因素,总结其临床特点及治疗方法.方法 连续收集合并脉络膜脱离的高度近视黄斑裂孔性视网膜脱离的病例10例(A组),并以同一时期不伴脉络膜脱离的高度近视黄斑裂孔性视网膜脱离病例12例为对照(B组),对比两组发病年龄、病程、术前屈光度、眼轴、眼压、视网膜脱离范围以及术后视网膜复位、视功能恢复等情况.结果 A组发病年龄大、近视度数高、眼压低、视网膜脱离范围大,与B组相比差异有统计学意义(P<0.05),其中眼压差异显著(P<0.01);两组的一次玻璃体切割手术视网膜复位率相近,A组为80%,B组为83%,但A组术后视力≥0.02的比例低(P=0.048).结论 高度近视黄斑裂孑L性视网膜脱离一旦合并脉络膜脱离常伴有年龄大、病程长、近视度数高、视网膜脱离广泛和显著低眼压等特点.适时采用玻璃体切割合并硅油填充术可达到与不合并脉络膜脱离组相近的视网膜复位率,但视力预后仍较差.

Analysis of the relative factors for rhegmatogenous retinal detachmort associated with choroidal detachment with macular hole in high myopia

Objective To evaluate the risk factors and therapy for rhegmatogenous retinal detachment (RRD)associated with choroidal detachment(ChD)with macular hole in high myopia.Method 10 consecutive eyes (group A)with rhegmatogenous retinal detachment associated with choroidal detachment with macular hole in high myopia were reviewed, and 12 similar eyes(group B)without choroidal detachment in the same period were enrolled as controls.Age of onset, course of disease, degree of myopia, intraocular pressure, extent of RD,retinal reattachraent status and visual acuity were compared in all patients.Rusults In group A,the average age of onset is older, the degree of myopia is higher, the intraocular pressure is lower, and RE) is more extensive compared with group B (P <0.05).The proportions of retinal reattachment after first pars plana vitrectomy with silicon oil were similar:the percentage in group A is 80%, in group B is 83%.But the proportion of visual acuity after surgery better than 0.02 in group A is lower than that of group B(P=0.048).Conelusion RRD -ChD with macular hole in high myopia is often seen in old patients with seriously high myopia, low intraocular pressure and extensive retinal detachment.Although retinal reattachment status after first pars plana vitrectomy with silicon oil are similar,the visual acuity after surgery is lower in patients associated with ChD compared with patients without ChD.