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病理性近视最新资料

Ohno-Matsui K, Lai TY, Lai CC, et al.

期刊名称:Prog Retin Eye Res

卷期:2016年5月第52卷

关键词:
病理性 资料

祝磊 河南省眼科研究所副所长,主任医师,角膜专业组组长。中华眼科学会角膜学组委员,中华眼科学会防盲治盲学组委员。

近视已经逐渐成为严重的公共健康问题,也是眼科学术界重点研究的课题之一。近些年的研究有了很大进展,除了近视度数和眼轴长度等传统的检测指标,对脉络膜视网膜萎缩和后葡萄肿在病理性近视中的作用有了新的认识,同时引入了OCT3DMRI等更精密的检查手段观察近视的病理变化,指导临床诊疗。基于研究的新成果,提出了新的治疗方法,如抗新生血管的治疗、玻璃体视网膜手术,取得了一定的疗效。本文有益于提高医生对近视尤其是病理性近视的认识,对于指导临床工作有积极意义。

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摘要

摘要:病理性近视并发症是视力障碍和失明的主要原因,特别是在东亚地区。病理性近视眼可能由于黄斑区,周边视网膜和视神经的各种病理损害而出现最佳矫正视力缺失。尽管其很重要,但目前病理性近视的定义已经不一致。单独屈光不正或轴向长度往往不能充分反映“病理性近视”。后巩膜葡萄肿,是病理性近视的一个标志病变,也可发生于非高度近视眼。最近流行病学研究中已经提出了一种规范其定义的近视黄斑病变修订分类系统。在META-PM(病理性近视meta分析)研究分类中,病理性近视定义为具有脉络膜视网膜萎缩等于或比弥漫性萎缩更严重的眼。此外,新型成像技术的出现,如光学相干断层扫描(OCT)和三维磁共振成像(3D MRI),使我们能够详细观察病理性近视各种特异性病理表现。新疗法,包括抗血管内皮生长因子剂玻璃体内注射和玻璃体视网膜手术的进步已经大大提高了患者的病理性近视的预后。这篇综述旨在提供病理性近视领域相关话题的最新资料,并概述其未来要需要解决的遗留问题。

Complications from pathologic myopia are a major cause of visual impairment and blindness, especially in east Asia. The eyes with pathologic myopia may develop loss of the best-corrected vision due to various pathologies in the macula, peripheral retina and the optic nerve. Despite its importance, the definition of pathologic myopia has been inconsistent. The refractive error or axial length alone often does not adequately reflect the 'pathologic myopia'. Posterior staphyloma, which is a hallmark lesion of pathologic myopia, can occur also in non-highly myopic eyes. Recently a revised classification system for myopic maculopathy has been proposed to standardize the definition among epidemiological studies. In this META-PM (meta analyses of pathologic myopia) study classification, pathologic myopia was defined as the eyes having chorioretinal atrophy equal to or more severe than diffuse atrophy. In addition, the advent of new imaging technologies such as optical coherence tomography (OCT) and three dimensional magnetic resonance imaging (3D MRI) has enabled the detailed observation of various pathologies specific to pathologic myopia. New therapeutic approaches including intravitreal injections of anti-vascular endothelial growth factor agents and the advance of vitreoretinal surgeries have greatly improved the prognosis of patients with pathologic myopia. The purpose of this review article is to provide an update on topics related to the field of pathologic myopia, and to outline the remaining issues which need to be solved in the future.


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