五例高度近视黄斑劈裂的分析研究

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1、授予单位代码10089学号或申请号20153287中国图书分类号R774.1HebeiMedicalUniversity硕士学位论文专业学位五例高度近视黄斑劈裂的分析研究研究生：苏玉丹导师：董白霞副教授专业：眼科学二级学院：河北医科大学第二医院2018年3月目录中文摘要································································································1英文摘要················································

2、················································2病例分析五例高度近视黄斑劈裂的分析研究病例资料································································································4附图································································································9附表··············

3、··················································································15讨论································································································18结论·································································································2

4、1参考文献·································································································21综述高度近视黄斑劈裂的研究进展·····················································24致谢································································································33个人简历······

5、··························································································34中文摘要五例高度近视黄斑劈裂的分析研究摘要高度近视黄斑劈裂(myopicfoveoschisis，MF)作为高度近视的并发症之一，是指黄斑部视网膜神经上皮层间发生分离。根据光学相干断层扫描(opticalcoherencetomography，OCT)观察结果，将MF可能的发病机制概括为以下三点:（1）玻璃体不全后脱离产生的牵引力。（2）内界膜的僵化和内层细胞的牵引力以及硬化的视网

6、膜血管所引起。（3）不断增加的眼轴长度和后巩膜葡萄肿所引起的离心性牵引。手术是目前治疗MF的唯一方法，因其致病因素的不明确导致手术方式选择尚不统一。目的：通过报道5例高度近视黄斑劈裂的病例，了解该疾病可能的发病机制，为临床上正确选择手术方式提供思路。方法：通过比较5例MF患者术前、术后的最佳矫正视力（bestcorrectedvisualacuity，BCVA）、黄斑区视网膜劈裂的最高值（maximumfovealthickness，MxFT）、眼轴长度（axiallength，AL）、多焦视网膜电图（multifocalelectroretinogram，mf

7、ERG）的b波振幅等视功能指标，探讨不同术式对术后效果的影响。结论：对于初学者来说，内界膜撕除与否应建立在避免造成黄斑裂孔等医源性损伤的前提下，不必强行剥除。巩膜缩短术可以有效缩短眼轴长度，有效缓解了巩膜扩张的外向牵引力，促使视网膜与巩膜的贴合，同时增强视网膜层间的紧密度，促使黄斑区视网膜劈裂复位，有可能会成为以后与MF相关的重点研究方向。关键词：高度近视,黄斑劈裂,玻璃体切除,内界膜撕除,巩膜缩短1英文摘要AnalysisoffivecasesofmyopicfoveoschisisABSTRACTMyopicfoveoschisisisoneofthecom

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