Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University (TMDU) Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Sci Rep. 2021 Aug 30;11(1):17330. doi: 10.1038/s41598-021-96783-w.
The purpose of this study was to determine the relationship between a posterior vitreous detachment (PVD) and retinoschisis (RS) in 73 highly myopic (HM) young patients age 16.4 ± 6.9 years and 24 non-HM children age 8.4 ± 1.5 years. The presence of the paravascular retinal abnormalities was determined in the images obtained by a ultra-widefield OCT (UWF OCT) instrument with an image field of 23 × 20 mm. The results showed that a partial PVD was detected in 15 (21%) of the HM patients, and the number increased significantly with increasing age (P = 0.02). PVDs of any type were not found in the non-HM eyes. The number of microvascular folds also increased with age in the HM patients (P = 0.03). Medium-reflective columnar tissues were present between the detached vitreous and inner retinal surface in 4 (5%) eyes of the HM patients. Myopic RS was found in 3 (4%) HM patients in the paravascular area but not in the macular area. These results suggest that early partial PVD may play a role in pathological and proliferative vitreous changes of HM eyes. An intense vitreoretinal traction with bridging tissues may cause the various paravascular retinal abnormalities. In HM eyes, paravascular RS is already present at an early age which may progress to macular RS with aging.
本研究旨在探讨 73 例高度近视（HM）青年患者（年龄 16.4±6.9 岁）和 24 例非 HM 儿童（年龄 8.4±1.5 岁）的后玻璃体脱离（PVD）与格子样视网膜劈裂（RS）之间的关系。通过超宽视野 OCT（UWF OCT）仪器获取的图像，确定视网膜旁血管异常的存在，该仪器的图像视野为 23×20mm。结果显示，15 例（21%）HM 患者存在部分 PVD，且随年龄增长而显著增加（P=0.02）。非 HM 眼未发现任何类型的 PVD。HM 患者的微血管褶皱数量也随年龄增长而增加（P=0.03）。在 4 例（5%）HM 患者的眼中，脱离的玻璃体和内视网膜表面之间存在中等反射柱状组织。HM 患者的血管旁区域发现 3 例（4%）近视性 RS，但在黄斑区域未发现。这些结果表明，早期的部分 PVD 可能在 HM 眼的病理性和增殖性玻璃体改变中起作用。强烈的玻璃体视网膜牵引和桥接组织可能导致各种血管旁视网膜异常。在 HM 眼中，血管旁 RS 早在年轻时就已经存在，随着年龄的增长可能会进展为黄斑 RS。
