中华眼底病杂志

中华眼底病杂志

近视性黄斑病变的进展模式及自然病程

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豹纹状眼底、漆裂样纹改变、弥漫性视网膜脉络膜萎缩、斑块状视网膜脉络膜萎缩、脉络膜新生血管(CNV)、Fuchs斑、后巩膜葡萄肿等近视性黄斑病变是目前影响高度近视眼视功能下降的主要原因。豹纹状眼底改变是最初的近视性视网膜病变。漆裂样纹是高度近视眼底后极部特有的一种病变,当漆裂样纹宽度增加或进展为漆裂样纹斑块状萎缩时,要注意监测CNV的发生。近视性黄斑病变的进展模式包括以下两种:(1)豹纹状眼底——漆裂样纹——漆裂样纹型斑块状萎缩——萎缩边缘CNV生成——黄斑萎缩;(2)豹纹状眼底——弥漫性视网膜脉络膜萎缩——萎缩区域扩大——后极部斑块状萎缩伴弥漫性视网膜脉络膜萎缩、斑块状萎缩发生在后巩膜葡萄肿边缘。了解这些病变进展模式及其自然病程有助于临床进一步认识高度近视病程。

Myopic macularpathy is the main cause of the decline of visual function in high myopia, which including tigroid fundus, lacquer cracks, diffuse retinal choroid atrophy, plaque retinal choroid atrophy, choroidal neovascularization (CNV), Fuchs spot and posterior staphyloma. The tigroid fundus is the initial myopic retinopathy. The lacquer cracks is a special lesion in the posterior pole of high myopia. When the lacquer cracksen enlarge or lacquer cracks progress to plaque retinal choroid atrophy should be paid to monitoring the occurrence of CNV. Myopic macularpathy progression include two mode. One is from tigroid fundus——lacquer cracks——plaque retinal choroid atrophy——CNV to macular atrophy. And the other is from tigroid fundus——diffuse retinal choroid atrophy——atrophy enlarge to diffuse retinal choroid atrophy with plaque retinal choroid atrophy or plaque retinal choroid atrophy occurence on the border of posterior staphyloma. Understanding the progression patterns and natural course of these lesions will help the clinic to further understand the course of high myoipa.

关键词: 近视,退行性/并发症; 脉络膜新生血管化; 综述

Key words: Myopia,degenerative/complications; Choroidal neovascularization; Review

引用本文: 刘维锋, 黄国富, 刘莉莉. 近视性黄斑病变的进展模式及自然病程. 中华眼底病杂志, 2018, 34(5): 508-511. doi: 10.3760/cma.j.issn.1005-1015.2018.05.023 复制

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