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中华眼科医学杂志(电子版) ›› 2021, Vol. 11 ›› Issue (04) : 234 -241. doi: 10.3877/cma.j.issn.2095-2007.2021.04.008

综述

特发性黄斑裂孔发病机制、诊断及治疗的研究进展
陈昱凝1, 沈畅1, 李洋1, 魏文斌1,†()   
  1. 1. 100730　首都医科大学附属北京同仁医院　北京同仁眼科中心　眼内肿瘤诊治研究北京市重点实验室　北京市眼科学与视觉科学重点实验室　医学人工智能研究与验证工信部重点实验室
  • 收稿日期:2021-06-20 出版日期:2021-08-28
  • 通信作者: 魏文斌
  • 基金资助:
    首都卫生发展科研专项(首发2020-1-2052); 北京市科委科技计划项目(Z201100005520045，Z181100001818003); 北京市医院管理局"登峰"人才培养计划(DFL20150201); 国家自然科学基金项目(82101180); 北京市自然科学基金资助项目(7204245); 北京市教育委员会科技发展计划一般项目(KM202010025018); 北京市医院管理中心"青苗"计划专项经费资助(QMS20190203); 北京市东城区优秀人才培养计划(2018)

Progress in diagnosis and treatment of idiopathic macular hole

Yuning Chen1, Chang Shen1, Yang Li1, Wenbin Wei1,†()   

  1. 1. Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab., Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
  • Received:2021-06-20 Published:2021-08-28
  • Corresponding author: Wenbin Wei
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陈昱凝, 沈畅, 李洋, 魏文斌. 特发性黄斑裂孔发病机制、诊断及治疗的研究进展[J]. 中华眼科医学杂志(电子版), 2021, 11(04): 234-241.

Yuning Chen, Chang Shen, Yang Li, Wenbin Wei. Progress in diagnosis and treatment of idiopathic macular hole[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2021, 11(04): 234-241.

特发性黄斑裂孔(IMH)是指除明确相关原发性病变如高度近视和眼外伤等外发生的黄斑中心凹区全层神经上皮缺失，临床上主要表现为视力下降、视物变形和中心暗点。根据眼底照像和光学相干断层成像等检查结果，国际玻璃体黄斑牵拉学组建议临床上将IMH分为4期以指导治疗和评估预后。近年来，随着对其发病机制研究的深入和手术技术的提高，IMH的治疗方式也趋于多样化和精准化，本文中笔者就IMH的发病机制、临床诊断、治疗方法和预后评估的研究进展进行综述。

关键词: 特发性黄斑裂孔, 奥克纤溶酶, 玻璃体切除术

Idiopathic macular hole (IMH) refers to the absence of full-thickness neuroepithelium in the foveal area of the macula in addition to clearly related primary diseases such as high myopia and trauma. The main clinical manifestations of IMH include decreased vision, metamorphopsia and central dark spots. According to the examination results from fundus image and optical coherence tomography, the International Vitreomacular Traction Study recommends that IMH could be divided into four phases to guide treatment and assess prognosis in clinical. With the deepening of its pathogenesis researches and the improvement of examinations and surgical techniques, the treatment of IMH has also become more diversified and precise. The progress of the pathogenesis, clinical diagnosis, treatment and prognosis of IMH were reviewed in this paper.

Key words: Idiopathic macular hole, Ocriplasmin, Vitrectomy
图1 黄斑裂孔各临床分期光学相干断层扫描的典型图像　图A示黄斑裂孔Ⅰ期；图B示黄斑裂孔Ⅱ期；图C示黄斑裂孔Ⅲ期；图D示黄斑裂孔Ⅳ期
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