| Objective: Pathological myopia is one of the fundus maculopathy which leads to low-vision or permanent visual loss at present. The main complication associated with central vision declined include choroidal neovascularization(CNV), Macular hemorrhage et al. But so far its mechanism is not clear, and we still have no special medical therapy. Scleral support surgery and the laser photocoagulation of CNV may have some effect, but its long-dated therapeutic effect and the choice of adaptive symptom, time is not clear. We analyzed generally the clinical character, the blood dynamic feature of retina-choroid, the image feature of FFA and ICGA in pathological myopia, compared the alteration of blood dynamic and image features between the case group and the comparative group. The aim is to discuss the blood dynamic feature in the pathological myopia, evaluate the effect of FFA and ICGA in the diagnosis and guidance of therapy, offer the consulted bases for searching more effective and reasonable clinical therapies.Methods: 1 52 cases(104 eyes) were investigated, which were diagnosed as PM gathered from 10,2001-12,2003. Recorded the generic complexions, underwent retinoscopy, ocular examination, fundus color ophthalmoscope, A/Bultrasonography, simultaneous FFA and ICGA with the confocal scaning laser ophthalmoscope. Recorded the sex, age, course, diopter, ocular axis, irrigation time of retina-choroid artery and vein. Measured the size of myopia arcs and got the ratio between it and optic disc. Compared the length of ocular axis, irrigation time of fundus vessels between the case group and the comparative group, analyzed the iconographic characteristics of angiography in PM and the relativity between irrgation time of fundus vas and various factors.2 All data were analyzed by SPSS 10.0 software package.Results: 1 In 52 PM cases, male 20 cases(40 eyes,38.5%), female 32 cases(64 eyes,61.5%), the proportation is 0.63(M:F); age ranged 15-77, average age 4; diopters ranged -6.00D—20.00D,average -11.50D; ocular axis ranged 25.91-35.02mm, average 29.94mm. The comparative group is 20 cases(40 eyes), male 8 cases(16 eyes, 40%), female 12 cases(24 eyes, 60%), the proportation is 0.67(M:F); age ranged 18-70, average age 45; diopter of 40 eyes^-0.50D; average ocular axis 25.06mm.2 In the case group the earliest irrigation of the central retinal arties appeared at the time of 11.16s, the late time 25.03s, the mean time 13.14 + 2.98s; the earliest time of the central veins 12.43s, the late time 29.25s, the mean time 15.07 ±3.01s; the earlist irrigation of choroidal arties at the time of 9.09s, the late time 23.6s, the mean time 11.96±2.19s; the earliest time of choroidal veins 10.64s, the late time 28.54s, themean time 13.45±2.7Is. Compared with normal comparative group, it had significant difference(P<0.05), and there were corresponding relationship among the time of fundus vessels and ocular axis, diopter, course and the size of myopia arcs; on the contrary there were no corresponding relationship with sex, age.3 The result of artery phase of FFA showed the diffuse background fluorescein of choroids, block hypofluorescence area in the poterior ocular fundus or macula area, larger choroidal vessels was evident in the great hypofluorescence area. During the vein phase, showed the hypofluorescence of the atrophic degeneration area, hyperfluorescence at the margins of the area, and the boundary is not clear. Artery-phase ICG study demonstrates the artery dilated,turbulence, the dilated tortuous retrobulbar arteries and could be seen to pulsate. Vein-phase ICG study demonstrates the abnormity of vortex vein. Lacquer crack was evident on FFA in 30 eyes(28.8%), early-phase demonstrates focal spots of hyperfluorescence caused by RPE degenerative changes, late-phase is not clear because of the hyperfluorescence background. Lacquer crack was evident on ICGA in 44 eyes (42.3%), demonstrates durative hypofluorescence, and its amount, length, range are all larger than the demonstration on FFA. Fundus hemorrhage were showed in 20 eyes , FFA demonstrates durative obscur fluorescence around which the hyperfluorescence of lacquer crack were apperent in 4 eyes... |
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