Tanaka Yuichiro, Shimada Noriaki, Ohno-Matsui Kyoko
Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan.
Am J Ophthalmol. 2015 Apr;159(4):677-82. doi: 10.1016/j.ajo.2015.01.004. Epub 2015 Jan 9.
To investigate the morphologic changes along the edge of posterior staphyloma in highly myopic eyes with patchy chorioretinal atrophy and to identify the relationship between retinal thinning and the visual field (VF) defects found in these eyes.
Retrospective, observational case series.
Twenty eyes (17 patients) with pathologic myopia (myopic refractive error ≥ 8 diopters or an axial length ≥ 26.5 mm) and patchy atrophy along the staphyloma edge were analyzed retrospectively. The VFs were obtained by Goldmann kinetic perimetry.
In the area of patchy atrophy, the inner retinal tissue was very thin or completely absent. Any remnants of the retinal tissue appeared to be adherent to the layer of large choroidal vessels or to the sclera. The mean thickness of the retina at its thinnest point in the area was 51.6 ± 29.0 μm in 20 eyes. The retina was thinner than 50 μm at its thinnest point in 12 (60.0%) of the 20 eyes, and the mean retinal thickness at its thinnest point in these 12 eyes was 32.1 ± 16.0 μm (range, 4 to 49 μm). Nineteen eyes (VF of 1 eye was not determined) had very similar VF findings by Goldmann perimetry, that is, a defect of the sector corresponding to the course of retinal nerve fiber over the patchy atrophy.
The results show that the thickness of not only the outer retina, but also of most of the inner retina, including the nerve fiber layer, is significantly thinner at the staphyloma edge. Such damage to the inner retina along the staphyloma edge causes the VF defects in highly myopic eyes.
研究高度近视合并斑片状脉络膜视网膜萎缩患者后巩膜葡萄肿边缘的形态学变化，并确定视网膜变薄与这些眼中发现的视野（VF）缺损之间的关系。
回顾性观察病例系列。
回顾性分析20只眼（17例患者），这些患者患有病理性近视（近视屈光不正≥8屈光度或眼轴长度≥26.5毫米）且巩膜葡萄肿边缘有斑片状萎缩。通过Goldmann动态视野计获得视野。
在斑片状萎缩区域，视网膜内层组织非常薄或完全缺失。视网膜组织的任何残余部分似乎都附着在大脉络膜血管层或巩膜上。20只眼中该区域视网膜最薄点的平均厚度为51.6±29.0μm。20只眼中有12只（60.0%）在最薄点处视网膜厚度小于50μm，这12只眼最薄点处的平均视网膜厚度为32.1±16.0μm（范围为4至49μm）。19只眼（1只眼的视野未测定）通过Goldmann视野计检查有非常相似的视野结果，即与斑片状萎缩上方视网膜神经纤维走行相对应的扇形缺损。
结果表明，不仅视网膜外层，而且包括神经纤维层在内的大部分视网膜内层在巩膜葡萄肿边缘处均明显变薄。巩膜葡萄肿边缘处视网膜内层的这种损伤导致高度近视眼中的视野缺损。
