摘要
目的探讨飞行员患黄斑前膜(epiretinal membrane,ERM)的发病机制、临床特点、诊断与治疗,分析黄斑前膜与飞行的关系,探讨飞行员黄斑前膜航空医学鉴定问题。方法分析1例黄斑前膜飞行员的临床资料及复习相关文献。结果本例黄斑前膜起病无明显诱因及相关性眼病,起始症状、体征不明显。入院前约半年时间感觉视物轻微变形,未引起注意,此次疗养体检时不经意间提及视物变形症状。做光学相干断层扫描(optical coherence tomography,OCT)及眼底荧光血管造影(fundus fluorescence angiography,FFA)检查,确诊为黄斑前膜。经3个月的地面观察后复飞,限双座,健康等级乙,并每半年复查一次。1年半后再复查时黄斑前膜已自行剥离,视物变形症状消失,结论为飞行合格,健康等级甲。结论黄斑前膜早期症状轻微,不易察觉,需尽早做出诊断,避免误诊。
Objective To investigate the pathogenesis,clinical characteristics,diagnosis and treatment of epiretinal membrane(ERM)in pilots,to analyze the relationship between ERM and flight,and to discuss the medical identification of ERM in pilots.Methods The clinical data of a pilot with ERM was analyzed and the related literatures were reviewed.Results In this case,the pilot with ERM did not have obvious causes of macular membrane onset and related eye diseases,and the initial symptoms and signs were atypical.About half a year before admission,the pilot felt slightly deformed vision,and did not concern about it.During the physical examination of this convalescence,the symptoms of deformed vision were inadvertently mentioned.The pilot was finally diagnosed as ERM by optical coherence tomography(OCT)and fundus fluorescence angiography(FFA).After 3 months of ground observation,the pilot returned to flight but limited to two-seat flight with a health grade of B.The pilot was re-examined every six months.The re-examination at 1.5 years showed that the epiretinal membrane was self-peeling,and the symptoms of visual deformation disappeared.The pilot was assessed qualified for flight with the health grade of A.Conclusion The early symptoms of ERM are mild and easy to be neglected.An early diagnosis of ERM is necessary to prevent misdiagnosis.
作者
严冬
李海立
王开辉
YAN Dong;LI Hai-li;WANG Kai-hui
出处
《中国疗养医学》
2023年第12期1341-1344,共4页
Chinese Journal of Convalescent Medicine
关键词
飞行员
黄斑前膜
医学鉴定
Pilo
Epiretinal membrane
Medical identification
