摘要
病理性近视脉络膜新生血管(PM-CNV)是病理性近视严重威胁视力的一大并发症,表现为位于或靠近视网膜中央凹的扁平、小、灰白色病变,伴或不伴黄斑出血,通常有少量渗出性改变。临床表现为视变形、中央或旁中央暗点以及中央视力下降。其发病机制是眼球的过度伸长超过26mm和屈光不正大于-6D(等效球径)使脉络膜和视网膜色素上皮层被机械拉伸和变薄,从而导致视网膜的各种退行性改变,如豹纹状眼底、脉络膜视网膜萎缩、Bruch膜机械破裂和CNV的形成。近视性视网膜病变是目前眼底病研究的热点。随着眼底疾病诊断工具的精密化及治疗手段的更新,对PM-CNV的诊断基于各种影像学检查手段,可以在一定程度上区分PM-CNV与其他原发疾病引起的CNV,如AMD、特发性CNV、多灶性脉络膜炎、点状脉络膜病变以及漆裂纹形成引起的病理性近视性黄斑出血。当前,激光视网膜光凝、维替泊芬光动力疗法、经瞳孔温热疗法、后路玻璃体切除术、玻璃体抗VEGF药物注射术均可治疗病理性近视脉络膜新生血管。本研究发现,许多眼科疾病产生的根源为视网膜脉络膜组织结构异常,因而需要了解视网膜正常的组织结构及引发近视性视网膜病变的因素。本研究将借助光学相干断层成像对近视性视网膜脉络膜组织结构进行分析,并对近视性视网膜病变的研究治疗进展进行综述。
Pathological myopia with choroidal neovascularization(PM-CNV)is a major complication of pathological myopia that seriously threatens vision,with manifestations of flat,small,grayish white lesions located in or near central fovea of retina,with or without macular hemorrhage,and usually with small amounts of exudative changes.Clinical manifestations include visual deformation,central or paracentral scotoma,and decreased central vision,with pathogenesis of excessive elongation of the eyeball exceeding 26 mm and refractive error exceeding-6D(equivalent spherical diameter),which causes mechanical stretching and thinning of choroid and retinal pigment epithelium layers,various degenerative changes of the retina,including leopard shaped fundus,chorioretinal atrophy,mechanical rupture of Bruce membrane,and formation of CNV.Myopic retinopathy is a hot research topic in fundus diseases currently.with precision of diagnostic tools for fundus diseases and update of treatment methods,diagnosis of PM-CNV can distinguish PM-CNV from CNV caused by other primary diseases to some extent based on various imaging examination methods,including AMD,idiopathic CNV,multifocal choroiditis,punctate choroidal lesions,and pathological myopia macular hemorrhage caused by paint crack formation.Currently,laser retinal photocoagulation,vitipofen photodynamic therapy,transpupillary thermotherapy,posterior vitrectomy,and intravitreal injection of anti VEGF drugs can all be used to treat pathological myopia with choroidal neovascularization.It is found root cause of many ophthalmic diseases is abnormal tissue structure of retina and choroid.Therefore,it is necessary to understand normal tissue structure of retina and influencing factors of myopic retinopathy.The article analyzes tissue structure of myopic retina and choroid with help of optical coherence tomography,and reviews research and treatment progress of myopic retinopathy.
作者
李薇
吴昌凡
LI Wei;WU Changfan(Wannan Medical College the Second Affiliated Hospital,Wuhu,Anhui 241000;Yijishan Hospital,Wannan Medical College the First Affiliated Hospital,Wuhu,Anhui 241000)
出处
《智慧健康》
2023年第24期71-75,共5页
Smart Healthcare
关键词
病理性近视性
脉络膜新生血管
治疗进展
Pathological myopia
Choroidal neovascularization
Treatment progress
