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[脉络膜脱离——发病机制、病因及临床特征]

[Choroidal detachment--pathogenesis, etiology and clinical features].

作者信息

Obuchowska Iwona, Mariak Zofia

机构信息

Z Kliniki Okulistyki Akademii Medycznej w Białymstoku.

出版信息

Klin Oczna. 2005;107(7-9):529-32.

Abstract

Serous choroidal detachment is characterized by exudative detachment of the retina and choroid following leakage of fluid from the choriocapillaris into suprachoroidal space. This accumulation of fluid has been known to be a complication of various intraocular surgeries (cataract, glaucoma and retinal detachment surgery), where hypotony is combined with postoperative inflammation. Among other non surgical conditions associated with uveal effusion are idiopathic (uveal effusion syndrome, microphthalmia) and inflammatory diseases (scleritis, sympathic ophthalmia, pars planitis, Harada's disease). Idiopathic serous detachment of choroids is caused by scleral abnormalities associated with hypoplasia or partial absence of the vortex venous system. The most cases of postoperative choroidal detachment resolve spontaneously. Resolution is usually associated with rapid normalization of the intraocular pressure and reduction of intraocular inflammation. The natural course of idiopathic condition is variable but tends to be prolonged with remissions and exacerbations. Surgical management involving vortex vein decompression and/or sclerotomy is the most effective treatment in this patients.

摘要

浆液性脉络膜脱离的特征是脉络膜毛细血管内的液体渗漏到脉络膜上腔后,视网膜和脉络膜发生渗出性脱离。已知这种液体蓄积是各种眼内手术(白内障、青光眼和视网膜脱离手术)的并发症,这些手术中眼压过低并伴有术后炎症。与葡萄膜渗漏相关的其他非手术情况包括特发性(葡萄膜渗漏综合征、小眼球)和炎症性疾病(巩膜炎、交感性眼炎、周边部葡萄膜炎、原田病)。特发性浆液性脉络膜脱离是由与涡状静脉系统发育不全或部分缺失相关的巩膜异常引起的。大多数术后脉络膜脱离病例可自发消退。消退通常与眼压迅速恢复正常和眼内炎症减轻有关。特发性疾病的自然病程多变,但往往会有缓解和加重的情况而迁延。对于这类患者,涉及涡状静脉减压和/或巩膜切开术的手术治疗是最有效的治疗方法。

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