Chuang E L, Bird A C
Department of Clinical Ophthalmology, Moorfields Eye Hospital, London.
Eye (Lond). 1988;2 ( Pt 1):106-13. doi: 10.1038/eye.1988.22.
Sixty-three eyes (in 59 patients) with tears of detached retinal pigment epithelium have been studied for a period of up to 10 years after the acute event. In the majority of cases a plaque of fibrous tissue was laid down gradually in the bed of the tear. In a few eyes the inner surface of Bruch's membrane appeared to remain relatively unaltered for up to 2 years, and in four eyes it was recovered with pigmented tissue resembling normal retinal pigment epithelium. These and other changes progressively obscured the distinctive feature of the original lesion; the nature of the original lesion was evident at 6 months in all cases, by 1 year it was recognisable in 94 per cent, by 2 years in 77 per cent and by 6 years in none. Choroidal neovascularisation was detected or suspected in one third of cases in the acute stages and developed in others weeks to months after the acute event. Alteration of the morphology occurred more quickly, and there was greater scarring, in those with new vessels or significant blood in the subretinal space, when compared with those without such features. Visual acuity was surprisingly good in many patients immediately after the tear. However, loss of vision accompanied the reactive tissue remodelling, and no case had long term retention of good visual acuity.
对59例患者的63只视网膜色素上皮脱离裂孔眼进行了研究，随访时间长达急性发病后10年。在大多数病例中，裂孔处逐渐形成一层纤维组织斑。少数眼中，布鲁赫膜的内表面在长达2年的时间里似乎相对未发生改变，4只眼中其被类似于正常视网膜色素上皮的色素组织覆盖。这些及其他变化逐渐掩盖了原发病变的特征；所有病例在6个月时原发病变的性质均清晰可见，1年时94%的病例可识别，2年时77%的病例可识别，6年时则无一例可识别。三分之一的病例在急性期检测到或怀疑有脉络膜新生血管，其他病例在急性发病数周或数月后出现。与无此类特征的患者相比，有新生血管或视网膜下间隙有大量血液的患者形态学改变更快，瘢痕形成更严重。许多患者在裂孔发生后视力出奇地好。然而，视力丧失伴随着反应性组织重塑，没有病例长期保持良好视力。
