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黄斑缺损的临床表现和诊断方法的系统评价。

A Systematic Review of the Clinical Manifestations and Diagnostic Methods for Macular Coloboma.

机构信息

Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.

Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

出版信息

Curr Eye Res. 2021 Jul;46(7):913-918. doi: 10.1080/02713683.2020.1853779. Epub 2021 Jan 22.

DOI:10.1080/02713683.2020.1853779
PMID:33478254
Abstract

: To present the clinical features of and diagnostic methods used for macular coloboma (MC), and to analyze the factors associated with best-corrected visual acuity (BCVA) in patients with MC.: A systematic review using the MEDLINE (PubMed), EMBASE, LILACS, and Cochrane databases was performed. The factors associated with BCVA were analyzed.: A total of 21 patients (mean age at diagnosis, 18.1 ± 14.6 years) with 36 eyes affected by MC (5 unilateral, 16 bilateral) were included in the study. All 21 patients (100%) had undergone a good-quality fundus examination. The size of the MC lesions ranged from 1.0 × 1.2 to 4.0 × 4.0 disc diameters (DD). Twenty-seven (73%) eyes had pigmented MC, seven (19%) had non-pigmented MC, and one (3%) had an unspecific type. The diagnosis was confirmed using spectral-domain optical coherence tomography (SD-OCT) in 16 (43.2%) eyes. A positive correlation was found between BCVA and the type of MC (β = 0.876, = .006) and abnormal eye movement (β = 0.087, = .018), and a negative correlation was found between BCVA and a contributory medical history of ventricular septal defect (β = -0.327, = .001).: Pigmented MC was the most common type and had the highest possibility of causing impaired vision in the affected eyes. Additionally, joint examinations should be applied for diagnostic confirmation of MC. Furthermore, fundoscopy, electroretinogram, electrooculography, fundus fluorescein angiography, and SD-OCT are all critical for differential diagnosis of MC-like lesions.

摘要

目的

介绍黄斑缺损(macular coloboma,MC)的临床特征和诊断方法,并分析其与最佳矫正视力(BCVA)相关的因素。

方法

系统检索 MEDLINE(PubMed)、EMBASE、LILACS 和 Cochrane 数据库,对 MC 患者 BCVA 的相关影响因素进行分析。

结果

本研究共纳入 21 例(诊断时平均年龄 18.1±14.6 岁)36 只眼的 MC 患者,其中单侧 5 例,双侧 16 例。21 例(100%)患者均接受了高质量的眼底检查。MC 病变大小为 1.0×1.2 至 4.0×4.0 视盘直径(disc diameter,DD)。27 只(73%)眼为色素性 MC,7 只(19%)眼为非色素性 MC,1 只(3%)眼为非特异性类型。16 只(43.2%)眼通过频域光学相干断层扫描(spectral-domain optical coherence tomography,SD-OCT)确诊。BCVA 与 MC 类型(β=0.876,P=.006)和眼球运动异常(β=0.087,P=.018)呈正相关,与室间隔缺损(ventricular septal defect,VSD)病史(β=-0.327,P=.001)呈负相关。

结论

色素性 MC 最常见,对视功能的损害最大。此外,应联合检查以明确 MC 的诊断。眼底检查、视网膜电图、眼电图、眼底荧光血管造影和 SD-OCT 对 MC 样病变的鉴别诊断均具有重要价值。

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