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目的研究先天性视盘小凹并发黄斑病变的形态学特征及其在病程发展和激光治疗后的变化情况。设计回顾性病例系列。研究对象12例先天性视盘小凹合并黄斑病变患者。方法对临床诊断为先天性视盘小凹的患者资料进行回顾性分析,依据彩色眼底照相、相干光断层扫描及荧光素眼底血管造影检查结果结合既往有关小凹发病机制的理论进行分析归纳。对其中4例进行沿小凹区域的视盘边缘光凝治疗,观察期6～30个月。主要指标视力及黄斑病变特征。结果12例患者均合并浆液性黄斑病变,其中2例为单纯神经上皮脱离,2例为单纯神经上皮层间劈裂,其余两者兼有。病变区与小凹之间存在明确关联关系,病变程度与病程及视力也相关。2例合并先天性脉络膜缺损。3例激光治疗有效。结论视网膜神经上皮层间劈裂和神经上皮脱离是先天性视盘小凹合并黄斑病变的重要形态学改变,正确认识其与病程发展的关系有助于加深对发病机制的认识。激光治疗对部分患者有效。
Objective To study the morphological features of congenital disc depression complicated with macular degeneration and its changes after the course of disease development and laser treatment. Design retrospective case series. Study object 12 cases of congenital disc small macular degeneration patients. Methods The data of patients diagnosed as congenital disc depression were analyzed retrospectively. Based on the findings of color fundus photography, coherence tomography and fundus fluorescein angiography, combined with the previous theories about the pathogenesis of small concave recess, we analyzed and summarized. In 4 cases, there was photocoagulation along the edge of the optic disc along the foveola. The observation period was 6 to 30 months. The main indicators of visual acuity and macular degeneration characteristics. Results All the 12 patients had serous maculopathy. Among them, 2 cases had pure neuroepithelial detachment, 2 cases had simple neuroepithelial dehiscence, and the rest had both. There is a clear relationship between the lesion and the lesion, and the degree of lesion is related to the course of disease and visual acuity. 2 cases with congenital choroidal defects. 3 cases of laser treatment effective. Conclusion The retinal neuroepithelial dehiscence and neuroepithelial detachment are the important morphological changes of congenital disc depression complicated with macular degeneration. Correct understanding of the relationship between them and the development of the disease process may help to deepen the understanding of the pathogenesis. Laser treatment is effective for some patients.