脉络膜脱离型视网膜脱离的临床研究

目的分析脉络膜脱离型视网膜脱离的临床特点。方法连续选择具有典型临床症状的脉络膜脱离型视网膜脱离患者61例61眼，与同期行玻璃体切割手术的非脉络膜脱离型孔源性视网膜脱离患者52例53眼进行对比研究，观察二者眼部体征及手术复位率等情况，并分析脉络膜脱离型视网膜脱离的好发因素。结果脉络膜脱离型视网膜脱离患者的眼前节反应重，眼压低（平均4mmHg），与一般孔源性视网膜脱离患者相比差异有统计学意义（P〈0．01）；采用玻璃体切割手术，前者的一次性手术复位率为65．51％，后者为88．68％，二者差异有统计学意义；脉络膜脱离型视网膜脱离组中年龄50岁以上及屈光度-6D以上的患者占总例数的50％以上，27．87％的患者合并有黄斑裂孔。结论脉络膜脱离伴视网膜脱离具有严重的葡萄膜炎和低眼压症状，老年人和高度近视者好发，多合并有黄斑裂孔，其手术复位率显著低于一般孔源性视网膜脱离者。

Clinical study on retinal detachment associated with choroidal detachment

Objective Retinal detachment associated with choroidal detachment is a complex condition in rhegmatogenous retinal detachment,and system comparative study on retinal detachment associated with choroidal detachment with rhegmatogenous retinal detachment is not seen in China.This study was to determine the clinical characteristics of retinal detachment associated with choroidal detachment.MethodsSixty-one eyes of 61 patients with retinal detachment associated with choroidal detachment from Beijing Tongren Hospital were enrolled,and 53 eyes from 52 patients with rhegmatogenous retinal detachment received vitrectomy in the same period were as controls.Anterior segments,intraocular pressure,degree of retinal detachment,extend of proliferative vitreoretinopathy and retinal reattachment statues were investigated in all patients for the evaluation of the risk factors of retinal detachment associated with choroidal detachment.ResultsThere were a significantly higher proportion of Tyndall sign and iris synechiae in retinal detachment associated with choriodal detachment eyes compared with controls(P<0.01);the intraocular pressure in the eyes with retinal detachment associated with choroidal detachment was significantly lower than the rhegmatogenous retinal detachment eyes (Mean:4mmHg versus 10.88mmHg) (P<0.01);more than 50% patients have hypermyopia (>6.0D) and the age were over 50 years;macular hole was seen in 17 cases (27.87%) in retinal detachment associated with choroidal detachment.In retinal detachment associated with choroidal detachment eyes,the percentage of retinal reattachment postoperatively was 65.51% and that of rhegmatogenous retinal detachment eyes was 88.68%,showing a significant difference between them (P<0.05).ConclusionRetinal detachment associated with choroidal detachment appear a severer inflammatory manifestations and low IOP and more frequently occur in old people or patients of hypermyopia.Macular hole often exists in such cases.The proportion of postoperative retinal reattachment is significantly lower than rhegmatogenous retinal detachment eyes.