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年轻人近视性黄斑劈裂的快速进展。

RAPID PROGRESSION OF FOVEOMACULAR RETINOSCHISIS IN YOUNG MYOPICS.

机构信息

Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai, China.

Department of Ophthalmology, Henry Ford Medical Center, West Bloomfield, Michigan.

出版信息

Retina. 2019 Jul;39(7):1278-1288. doi: 10.1097/IAE.0000000000002203.

Abstract

PURPOSE

To describe a foveomacular retinoschisis that has not been described.

METHODS

Patients with foveomacular retinoschisis were included. Exclusion criteria included refractive error over -6.00 diopters, presence of posterior staphyloma, positive RS1-gene mutation, family history of retinoschisis, optic disk abnormalities, or glaucoma. Vitrectomy was performed on eyes with functional or structural deterioration.

RESULTS

Seventeen eyes from 10 patients (15-30 years old, 8 females and 2 males) with foveoschisis were recruited, with bilateral involvement in 7 patients and unilateral in 3 patients. Vitrectomy was performed in 13 eyes (13/17, 76.5%). Seven eyes (6 patients) were operated soon after the first presentation because of poor vision and severe foveoschisis. Six eyes (6 patients) were operated 2 weeks to 13 months later because of deterioration of vision and foveoschisis. Preoperative vision was 20/134 ± 20/165, and postoperative vision was 20/25 ± 20/57, with visual improvement of 6.9 (4-14) lines. The mean postoperative follow-up period was 36.5 (15-69) months. Four eyes (4 patients) were asymptomatic, despite progression of foveoschisis. Three eyes (3 patients) maintained normal macula structures.

CONCLUSION

We report a foveomacular retinoschisis characterized by young age of onset, female predominant, no highly myopia, mostly bilateral involvement, and rapid progression of foveoschisis and visual acuity. Vitrectomy is effective in restoring anatomical structure and stabilize vision.

摘要

目的

描述一种尚未描述的黄斑劈裂。

方法

纳入黄斑劈裂患者。排除标准包括近视超过-6.00 度、存在后葡萄肿、RS1 基因突变阳性、视网膜劈裂家族史、视盘异常或青光眼。对功能或结构恶化的眼睛进行玻璃体切除术。

结果

10 例患者(15-30 岁,8 名女性和 2 名男性)的 17 只眼有黄斑劈裂,其中 7 例为双侧,3 例为单侧。对 13 只眼(13/17,76.5%)进行了玻璃体切除术。7 只眼(6 例)因视力差和严重黄斑劈裂在首次就诊后不久进行了手术。6 只眼(6 例)因视力和黄斑劈裂恶化在 2 周至 13 个月后进行了手术。术前视力为 20/134±20/165,术后视力为 20/25±20/57,视力提高 6.9(4-14)行。平均术后随访时间为 36.5(15-69)个月。尽管黄斑劈裂进展,但 4 只眼(4 例)无症状。3 只眼(3 例)保持正常的黄斑结构。

结论

我们报告了一种黄斑劈裂,其特征为发病年龄较轻,女性为主,无高度近视,多为双侧受累,黄斑劈裂和视力迅速恶化。玻璃体切除术可有效恢复解剖结构并稳定视力。

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