Hsiang Huang Wei, Ohno-Matsui Kyoko, Shimada Noriaki, Hayashi Kengo, Moriyama Muka, Yoshida Takeshi, Tokoro Takashi, Mochizuki Manabu
Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.
Am J Ophthalmol. 2008 Jul;146(1):102-110. doi: 10.1016/j.ajo.2008.03.010. Epub 2008 May 2.
To determine the morphologic features (grade and type) of posterior staphylomas and to analyze the relationship between the morphologic features and the incidence of myopic macular lesions.
Observational case series.
Two hundred and nine eyes of 108 consecutive patients with high myopia were studied. The grade of staphylomas was determined from B-scan ultrasonographic images across the optic disk. The type of staphyloma was determined by binocular funduscopy and was classified according to the criteria of Curtin. The participants were divided into two groups: younger than 50 years and 50 years and older. The long-term morphologic progression of staphylomas was analyzed in nine patients who were followed up for more than 20 years.
Ninety percent of 209 eyes had a staphyloma. The prevalence of staphylomas and more advanced grades of staphylomas (> grade 2) were significantly higher in the older than in the younger patients. The higher grades of staphylomas were associated with more severe myopic retinal degeneration. Type II staphyloma was the most prominent overall; however, in older subjects, the incidence of type II was decreased significantly, and that of type IX was increased significantly. The eyes with type IX staphyloma tended to have more severe myopic retinal degeneration than eyes with type II staphylomas. The long-term follow-up study demonstrated a progression from type II to type IX with increasing age.
These results suggest that the morphologic features of staphylomas worsens as the patient ages. The progression from type II to type IX probably increases the mechanical tension on the macular area of highly myopic eyes, which then leads to myopic fundus lesions.
确定后巩膜葡萄肿的形态学特征（分级和类型），并分析形态学特征与近视性黄斑病变发生率之间的关系。
观察性病例系列。
对108例连续的高度近视患者的209只眼进行研究。通过对视盘进行B超超声图像检查确定葡萄肿的分级。通过双眼眼底镜检查确定葡萄肿的类型，并根据柯廷标准进行分类。参与者分为两组：年龄小于50岁和50岁及以上。对9例随访超过20年的患者分析葡萄肿的长期形态学进展。
209只眼中90%有葡萄肿。年龄较大患者的葡萄肿及更高级别葡萄肿（>2级）的患病率显著高于年龄较小患者。较高等级的葡萄肿与更严重的近视性视网膜变性相关。总体上II型葡萄肿最为突出；然而，在老年受试者中，II型的发生率显著降低，IX型的发生率显著增加。IX型葡萄肿的眼睛往往比II型葡萄肿的眼睛有更严重的近视性视网膜变性。长期随访研究表明，随着年龄增长，从II型向IX型进展。
这些结果表明，葡萄肿的形态学特征随患者年龄增长而恶化。从II型向IX型的进展可能会增加高度近视眼睛黄斑区的机械张力，进而导致近视性眼底病变。
