病理性近视黄斑出血的眼底特征及光学相干断层扫描分析.docVIP

　　病理性近视黄斑出血的眼底特征及光学相干断层扫描分析 赵 婕1, 孙晓东2,陆 豪1,严 良1,秦 洁1 【摘要】 目的：探讨病理性近视黄斑出血的眼底改变及其光学相干断层扫描特征。方法：对42例43眼病理性近视(PM)黄斑出血患者进行眼底彩色照相、荧光素眼底血管造影(FFA)和光学相干断层扫描(OCT)检查。结果：病理性近视黄斑出血的表现分为两类：新生血管型：24例24眼，其眼底特征表现为出血灶呈类圆形，不超过1PD，周围少见渗出及水肿，部分可见新生血管膜;其FFA特征表现为典型性V 17眼(71%)，隐匿性V 7眼(29%);其OCT特征表现为21眼(87.5%)V呈纺锤形或类圆形团块状，呈强或中等强度反射，自视网膜色素上皮层向上突出，位于视网膜神经上皮层下，3眼(12.5%) V呈不规则增强紊乱的反射信号，位于视网膜色素上皮层平面。单纯型：18例19眼;其眼底特征表现为出血灶扁平，大小不等，边界欠整齐，周围无渗出及水肿，其FFA特征表现为出血遮蔽荧光，无V性高荧光征象，部分患眼可见漆裂纹样透见荧光;其OCT特征表现为色素上皮层下隆起低反射区，脉络膜毛细血管层光带连续。结论：病理性近视新生血管型黄斑出血绝大部分由典型性V引起，OCT的典型图像为色素上皮层局限的纺锤状或类圆形的强反射光团，边界较清，视网膜向上隆起，下方可有脉络膜遮蔽;单纯型黄斑出血表现为局限性色素上皮层出血性脱离，OCT检查有利于明确病理性近视黄斑出血的病变性质和病因，并有助于判断预后和指导治疗。 【关键词】 病理性近视;黄斑出血;脉络膜新生血管;光学相干断层扫描 　Optical coherence tomography and fundus fluorescein angiography for macular hemo?rrhage in pathological myopia 　　Jie Zhao1, Xiao?Dong Sun2, Hao Lu1, Liang Yan1, Jie Qin1 　　1Department of Ophthalmology, Baoshan District Central Hospital, Shanghai 201900, China; 2Department of Ophthalmology, the First People?s Hospital, Medical College of Shanghai Jiaotong University, Shanghai 200080, China 　　Correspondence to: Xiao?Dong Sun. Department of Ophthalmology, the First People?s Hospital, Medical College of Shanghai Jiaotong University, Shanghai 200080, China. xdsunsjtu.edu. 　　Received:2010?05?12 Accepted:2010?07?08 　　Abstract 　　?AIM: To evaluate the characterization of macular hemorrhage in pathological myopia (PM) ography (OCT) and fundus fluorescein angiography (FFA). 　　?METHODS: A series of retrospective cases study ?ed on 42 patients 43 eyes of PM acular hemorrhages. 　　?RESULTS: The causes and symptoms of PM acular hemorrhage could be divided into ts: neacular hemorrhage acular hemorrhage demonstrated oval, less than 1 disk diameter (PD), a and exudation around. And neembrana vasculosa can be seen partially. The FFA characterisitics erate, strong or medium reflection, sticking out up retinal pigment epithelial layers, under the epithelial layers of retinal neuroepithelial; 3 eyes (12.5%) V ay aggregate