Ito-Ohara M, Seko Y, Morita H, Imagawa N, Tokoro T
Department of Ophthalmology, Tokyo Medical and Dental University School of Medicine, Japan.
Ophthalmologica. 1998;212(1):23-9. doi: 10.1159/000027254.
Regional chorioretinal atrophy in the posterior fundus (patchy chorioretinal atrophy) in pathological myopia impairs vision severely when it covers the macula. The aim of this study was to assess the course of development and progression of patchy chorioretinal atrophy in pathological myopia. The location and progression of patchy chorioretinal atrophy that was either newly developed or had progressed during the follow-up period (mean 5.25 years) were analyzed. A total of 41 lesions of patchy atrophy were newly developed in 30 eyes of 25 patients. These lesions were more likely to occur in marginal regions of a posterior staphyloma but frequency per unit area was highest in the macula. There were 138 lesions of patchy chorioretinal atrophy that progressed in 75 eyes of 53 patients. Sixty percent of the lesions of patchy chorioretinal atrophy in marginal regions of a posterior staphyloma spread toward the center. Seventy percent of the lesions of patchy chorioretinal atrophy in the macula spread in all directions. Fluorescein angiography of newly developed patchy chorioretinal atrophy showed hyperfluorescence in 50% and hypofluorescence in 27%. Fluorescein angiography of progressive lesions of patchy chorioretinal atrophy showed hypofluorescence in 69%. Fluorescein angiography of some progressive areas of patchy chorioretinal atrophy, which showed a change from hyperfluorescence to hypofluorescence within several years, suggested that damage to the retinal pigment epithelium preceded the progression of the patchy chorioretinal atrophy. In conclusion, the patchy chorioretinal atrophy is most likely to occur in the macula and to enlarge in all directions. And it is suggested that the patchy chorioretinal atrophy which shows hyperfluorescence by fluorescein angiography should be kept under observation because our data suggest that this finding indicates progression in the future.
病理性近视患者眼底后部的局限性脉络膜视网膜萎缩（斑片状脉络膜视网膜萎缩）累及黄斑时会严重损害视力。本研究旨在评估病理性近视中斑片状脉络膜视网膜萎缩的发展和进展过程。分析了随访期间（平均5.25年）新出现或进展的斑片状脉络膜视网膜萎缩的位置和进展情况。25例患者的30只眼中共新出现41处斑片状萎缩病变。这些病变更易发生于后巩膜葡萄肿的边缘区域，但单位面积发生率在黄斑区最高。53例患者的75只眼中有138处斑片状脉络膜视网膜萎缩病变进展。后巩膜葡萄肿边缘区域60%的斑片状脉络膜视网膜萎缩病变向中心蔓延。黄斑区70%的斑片状脉络膜视网膜萎缩病变向各个方向扩散。新出现的斑片状脉络膜视网膜萎缩的荧光素血管造影显示，50%为高荧光，27%为低荧光。进展性斑片状脉络膜视网膜萎缩病变的荧光素血管造影显示，69%为低荧光。一些进展性斑片状脉络膜视网膜萎缩区域的荧光素血管造影显示，数年内从高荧光变为低荧光，提示视网膜色素上皮损伤先于斑片状脉络膜视网膜萎缩的进展。总之，斑片状脉络膜视网膜萎缩最易发生于黄斑区并向各个方向扩大。并且建议对荧光素血管造影显示高荧光的斑片状脉络膜视网膜萎缩进行观察，因为我们的数据表明这一发现预示着未来会进展。
