Department of Ophthalmology, Gunma University, School of Medicine, Maebashi, Japan.
Invest Ophthalmol Vis Sci. 2014 Mar 10;55(3):1447-52. doi: 10.1167/iovs.13-13496.
To observe vitreous changes in high myopia using swept-source optical coherence tomography (SS-OCT).
We performed slit-lamp biomicroscopy and SS-OCT in the highly myopic right eyes of 151 patients (mean age, 52.7 years; mean refraction, -11.4 diopters [D]) and the right eyes with no myopia of 363 healthy control volunteers (mean age, 52.8 years; mean refraction, -1.4 D). To estimate the sizes of the posterior precortical vitreous pockets (PPVPs), we measured the height between the fovea and the anterior border of the PPVPs.
Patients with partial posterior vitreous detachments (PVDs) around the macula and complete PVDs in high myopia were significantly (P < 0.0001) younger (47.1 ± 14.1 and 61.2 ± 12.0 years, respectively) than controls (59.0 ± 9.6 and 69.7 ± 6.6 years). The PPVPs with no PVDs were significantly (P < 0.001) higher in 32 eyes with high myopia (984 ± 292 μm) than 164 controls (553 ± 166 μm). After a complete PVD with a Weiss ring developed, the vitreous cortex was on the macula in 40.5% of the eyes with high myopia, which differed significantly (P < 0.0001) from the 8.7% of the controls. Myopic foveoschisis was present in 14 (9.3%) of 151 eyes. In eyes with foveoschisis, three (21.4%) eyes had partial PVDs and 11 (78.6%) eyes had complete PVDs; there was no residual cortex in 8 (72.7%) of 11 eyes with complete PVDs.
Highly myopic eyes may have larger PPVPs than normal eyes. Partial PVDs around the macula and complete PVDs occur at younger ages. The vitreous cortex more frequently remains on the macula after development of complete PVDs in highly myopic eyes.
使用扫频源光学相干断层扫描(SS-OCT)观察高度近视患者的玻璃体变化。
对 151 例(右眼,平均年龄 52.7 岁,平均屈光度-11.4 屈光度[D])高度近视患者和 363 例(右眼,无近视)健康志愿者的右眼进行裂隙灯显微镜和 SS-OCT 检查。为了评估后皮质玻璃体前囊(PPVPs)的大小,我们测量了黄斑前界与 PPVPs 前界之间的高度。
患有黄斑周围部分玻璃体后脱离(PVD)和完全 PVD 的高度近视患者明显(P<0.0001)比对照组年轻(分别为 47.1±14.1 和 61.2±12.0 岁,而对照组为 59.0±9.6 和 69.7±6.6 岁)。在 32 只无 PVD 的高度近视眼中,PPVPs 明显(P<0.001)高于 164 只对照组(553±166μm)(984±292μm)。在形成 Weiss 环的完全 PVD 后,高度近视眼的 40.5%(40.5%)的玻璃体皮质位于黄斑上,这与对照组的 8.7%(8.7%)有显著差异(P<0.0001)。151 只眼中有 14 只(9.3%)存在近视性黄斑劈裂。在有黄斑劈裂的眼中,3 只(21.4%)眼有部分 PVD,11 只(78.6%)眼有完全 PVD;在 11 只完全 PVD 眼中,有 8 只(72.7%)眼没有残留皮质。
高度近视眼的 PPVPs 可能大于正常眼。黄斑周围的部分 PVD 和完全 PVD 发生在较年轻的年龄。在高度近视眼中,完全 PVD 后,玻璃体皮质更频繁地留在黄斑上。