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中华眼科医学杂志(电子版) ›› 2021, Vol. 11 ›› Issue (06) : 380 -384. doi: 10.3877/cma.j.issn.2095-2007.2021.06.011

综述

近视眼牵引性黄斑病变相关因素的研究现状
张珂1, 刘武2,†()   
  1. 1. 100730　首都医科大学附属北京同仁医院2020级硕士研究生
    2. 100730　首都医科大学附属北京同仁医院　北京同仁眼科中心　北京市眼视光与视觉科学重点实验室
  • 收稿日期:2021-04-03 出版日期:2021-12-28
  • 通信作者: 刘武
  • 基金资助:
    国家重点研发计划(2017YFA0104103)

Advances on related factors of myopic traction maculopathy

Ke Zhang1, Wu Liu2,†()   

  1. 1. Master′s degree 2020, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
  • Received:2021-04-03 Published:2021-12-28
  • Corresponding author: Wu Liu
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张珂, 刘武. 近视眼牵引性黄斑病变相关因素的研究现状[J]. 中华眼科医学杂志(电子版), 2021, 11(06): 380-384.

Ke Zhang, Wu Liu. Advances on related factors of myopic traction maculopathy[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2021, 11(06): 380-384.

近年来，合并严重并发症的高度近视眼患者日益增多。近视眼牵引性黄斑病变(MTM)，是高度近视眼的并发症之一，其主要表现有黄斑区视网膜劈裂、黄斑区视网膜脱离及黄斑裂孔。MTM的发病机制较为复杂，与其相关的因素较多，可大致分为一般因素和眼球壁因素。了解各因素在其发病过程中的作用，有助于临床工作者正确判断病情，选择合适的手术时机。本文中笔者回顾近年来国内外的相关文献，对MTM相关因素的研究现状进行综述。

关键词: 高度近视, 视网膜劈裂, 视网膜脱离, 黄斑裂孔

In recent years, high myopia patients with serious complications have been increasing. Traction maculopathy in myopia (MTM) is one of the complications of high myopia, which characterized by the macular retinoschisis, macular retinal detachment and macular hole. The pathogenesis of MTM is complex, and has many related factors, which can be roughly divided into general factors and eye wall factors. Understanding the role of various factors in the pathogenesis of MTM is helpful for clinicians to correctly judge the condition and choose appropriate timing of surgery. In this paper, the relevant literature at home and abroad in recent years about MTM related factors were reviewed.

Key words: High myopia, Retinoschisis, Retinal detachment, Macular hole
表1 高度近视眼眼底病变一般因素相关研究的汇总
第一作者 发表年份 样本量 纳入研究的相关因素 结论(危险因素)
Ueda[5] 2020 2164 年龄、性别、眼轴及屈光度 年龄增大；眼轴增长
Liu[6] 2010 4439 性别、年龄及屈光度 年龄增大；屈光度加深
Koh[7] 2016 749 屈光度、眼轴及年龄 年龄增大；眼轴增长；屈光度加深
Lin[8] 2018 6830 年龄、性别及屈光度 女性；屈光度加深
Wong[9] 2020 21 264 年龄、性别、眼轴及屈光度 年龄增大；女性；眼轴增长；屈光度加深
表2 相关因素后巩膜葡萄肿相关研究的汇总
第一作者 发表年份 研究对象 结论
Numa[13] 2018 3748名志愿者的右眼，其中395名为高度近视眼患者 后巩膜葡萄肿在高度近视眼中的发病率较高；后巩膜葡萄肿相关因素为较大的年龄；后巩膜葡萄肿陡峭程度的相关因素为女性、老年人及眼轴
Zheng[14] 2020 117例(225只眼)高度近视眼患者 后巩膜葡萄肿发生的相关因素为较大的年龄、较深的屈光度及较长的眼轴；患有后巩膜葡萄肿的成人同时患近视眼牵引性黄斑病变的几率较大
[1]
Panozzo G, Mercanti A.Optical coherence tomography findings in myopic traction maculopathy[J].Arch Ophthalmol,2004,122(10):1455-1460.
[2]
Wong YL, Saw SM.Epidemiology of pathologic myopia in Asia and worldwide[J].Asia Pac J Ophthalmol (Phila),2016,5(6):394-402.
[3]
Ohno-Matsui K, Lai TYY, Lai CC,et al.Updates of pathologic myopia[J].Prog Retin Eye Res,2016,52:156-187.
[4]
Ruiz-Medrano J, Montero JA, Flores-Moreno I,et al.Myopic maculopathy: current status and proposal for a new classification and grading system (ATN)[J].Prog Retin Eye Res,2019,69:80-115.
[5]
Ueda E, Yasuda M, Fujiwara K,et al.Five-year incidence of myopic maculopathy in a general japanese population: the Hisayama study[J].JAMA Ophthalmol,2020,138(8):887-893.
[6]
Liu HH, Xu L, Wang YX,et al.Prevalence and progression of myopic retinopathy in Chinese adults: the Beijing Eye Study[J].Ophthalmology,2010,117(9):1763-1768.
[7]
Koh V, Tan C, Tan PT,et al.Myopic maculopathy and optic disc changes in highly myopic young Asian eyes and impact on visual acuity[J].Am J Ophthalmol.2016;164:69-79.
[8]
Lin C, Li SM, Ohno-Matsui K,et al.Five-year incidence and progression of myopic maculopathy in a rural Chinese adult population: the Handan Eye Study[J].Ophthalmic Physiol Opt,2018,38(3):337-345.
[9]
Wong YL, Zhu X, Tham YC,et al.Prevalence and predictors of myopic macular degeneration among Asian adults: pooled analysis from the asian eye epidemiology consortium[J].Br J Ophthalmol,2021;105(8):1140-1148.
[10]
刘晶晶. 高度近视人群眼底病变发生的临床研究[J]. 中国实用医药，2020, 15(28): 49-51.
[11]
陈静. 近视病因与发病机制的研究进展[J]. 中华实验眼科杂志，2012, 30(4): 376-379.
[12]
Ohno-Matsui K, Jonas JB.Posterior staphyloma in pathologic myopia[J].Prog Retin Eye Res,2019,70:99-109.
[13]
Numa S, Yamashiro K, Wakazono T,et al.Prevalence of posterior staphyloma and factors associated with its shape in the Japanese population[J].Sci Rep,2018,8(1):4594.
[14]
Zheng F, Wong CW, Sabanayagam C,et al.Prevalence, risk factors and impact of posterior staphyloma diagnosed from wide-field optical coherence tomography in Singapore adults with high myopia[J].Acta Ophthalmol,2021,99(2):e144-e153.
[15]
Frisina R, Gius I, Palmieri M,et al.Myopic traction maculopathy: diagnostic and management strategies[J].Clin Ophthalmol,2020,14:3699-3708.
[16]
Johnson MW.Posterior vitreous detachment: evolution and complications of its early stages[J].Am J Ophthalmol,2010,149(3):371-382.
[17]
Yonemoto J, Noda Y, Masuhara N,et al.Age of onset of posterior vitreous detachment[J].Curr Opin Ophthalmol,1996,7(3):73-76.
[18]
Vanderbeek BL, Johnson MW.The diversity of traction mechanisms in myopic traction maculopathy[J].Am J Ophthalmol，2012,153(1):93-102.
[19]
Takahashi H, Tanaka N, Shinohara K,et al.Importance of paravascular vitreal adhesions for development of myopic macular retinoschisis detected by ultra-widefield OCT[J].Ophthalmology,2021,128(2):256-265.
[20]
Ishida S, Yamazaki K, Shinoda K,et al.Macular hole retinal detachment in highly myopic eyes: ultrastructure of surgically removed epiretinal membrane and clinicopathologic correlation[J].Retina,2000,20(2):176-183.
[21]
Liu HY, Zou HD, Liu K,et al.Posterior vitreous cortex contributes to macular hole in highly myopic eyes with retinal detachment[J].Chin Med J (Engl),2011,124(16):2474-2479.
[22]
Itakura H, Kishi S, Li D,et al.Vitreous changes in high myopia observed by swept-source optical coherence tomography[J].Invest Ophthalmol Vis Sci,2014,55(3):1447-1452.
[23]
Song M, Shen M, Zhou Y,et al.Observation of vitreous features using enhanced vitreous imaging optical coherence tomography in highly myopic retinlschisis[J].Retina,2019,39(9):1732-1741.
[24]
Koh V, Cheung CY, Wong WL,et al.Prevalence and risk factors of epiretinal membrane in Asian Indians[J].Invest Ophthalmol Vis Sci,2012,53(2):1018-1022.
[25]
Kampik A.Pathology of epiretinal membrane, idiopathic macular hole, and vitreomacular traction syndrome.[J].Retina,2012,32(Suppl 2):S194-S199.
[26]
Muraoka Y, Tsujikawa A, Hata M,et al.Paravascular inner retinal defect associated with high myopia or epiretinal membrane.[J].JAMA Ophthalmol,2015,133(4):413-420.
[27]
Johnson MW.Myopic traction maculapathy：pathogenic mechanisms and surgical treatment[J].Retina,2012,32(Suppl 2):S205-S210.
[28]
Wu PC, Chen YJ, Chen YH,et al.Factors associated with foveoschisis and foveal detachment without macular hole in high myopia[J].Eye,2009,23(2):356-361.
[29]
Jose M, Pin A, GarcÍ A,et al.Relationship between Macular Bending and foveoschisis in myopic patients[J].Optom Vis Sci,2014,91(5):497-506.
[30]
陈璐，魏雁涛，方冬. 高度近视黄斑裂孔内界膜的超微结构及生物力学性能研究[J]. 中华实验眼科杂志，2020, 38(6): 482-487.
[31]
Ikuno Y, Tano Y.Vitrectomy for macular holes associated with myopic foveoschisis[J].Am J Ophthalmol,2006,141(4):774-776.
[32]
Sayanagi K, Ikuno Y, Tano Y.Tractional internal limiting membrane detachment in highly myopic eyes[J].Am J Ophthalmol,2006,142(5):850-852.
[33]
Yoshihara N, Yamashita T, Ohno-Matsui K,et al.Objective analyses of tessellated fundi and significant correlation between degree of tessellation and choroidal thickness in healthy eyes[J].PLoS One,2014,9(7):e103586.
[34]
Zhang Z, Wei Y, Jiang X,et al.Pars plana vitrectomy and wide internal limiting membrane peeling with perfluoropropane tamponade for highly myopic foveoschisis-associated macular hole[J].Retina,2017,37(2):274-282.
[35]
Wang JL, Wang YL.Long-term outcome of vitrectomy with suitable internal limiting membrane peeling and air tamponade for highly myopic foveoschisis-associated lamellar macular hole[J].J Ophthalmol,2020:2074037.
[36]
Ikuno Y, Gomi F, Tano Y.Potent retinal arteriolar traction as a possible cause of myopic foveoschisis[J].Am J Ophthalmol,2005,139(3):462-467.
[37]
Sayanagi K, Ikuno Y, Gomi F,et al.Retinal vascular microfolds in highly myopic eyes.[J].Am J Ophthalmol,2005,139(4):658-663.
[38]
Spencer LM, Foos RY.Paravascular vitreoretinal attachments: role in retinal tears[J].Arch Ophthalmol,1970,84(5):557-564.
[39]
Takahashi H, Tanaka N, Shinohara K,et al.Ultra-widefield optical coherence tomographic imaging of posterior vitreous in eyes with high myopia[J].Am J Ophthalmol,2019,206:102-112.
[40]
Shimada N, Ohno-Matsui K, Nishimuta A,et al.Detection of paravascular lamellar holes and other paravascular abnormalities by optical coherence tomography in eyes with high myopia[J].Ophthalmology,2008,115(4):708-717.
[41]
Vela JI, Sánchez F, Díaz-Cascajosa J,et al.Incidence and distribution of paravascular lamellar holes and their relationship with macular retinoschisis in highly myopic eyes using spectral-domain oct[J].Int Ophthalmol,2016,36(2):247-252.
[42]
Kamal-Salah R, Morillo-Sanchez MJ, Rius-Diaz F,et al.Relationship between paravascular abnormalities and foveoschisis in highly myopic patients[J].Eye (Lond)，2015，29(2):280-285.
[43]
Li T, Wang X, Zhou Y,et al.Paravascular abnormalities observed by spectral domain optical coherence tomography are risk factors for retinoschisis in eyes with high myopia[J].Acta Ophthalmol,2018,96(4):e515-e523.
[44]
Hsieh YT, Yang CM.Retinal detachment due to paravascular abnormalities-associated breaks in highly myopic eyes[J].Eye (Lond),2019,33(4):572-579.
[45]
Takahashi H, Tanaka N, Shinohara K,et al.Importance of paravascular vitreal adhesions for development of myopic macular retinoschisis detected by ultra-widefield OCT[J].Ophthalmology,2021,128(2):256-265.
[46]
Kobayashi H, Kishi S.Vitreous surgery for highly myopic eyes with foveal detachment and retinoschisis[J].Ophthalmology,2003,110(9):1702-1707.
[47]
Fujimoto M, Hangai M, Suda K，et al.Features associated with foveal retinal detachment in myopic macular retinoschisis[J].Am J Ophthalmol,2010,150(6):863-870.
[48]
Shimada N, Tanaka Y, Tokoro T,et al.Natural course of myopic traction maculopathy and factors associated with progression or resolution[J].Am J Ophthalmol,2013,156(5):948-957.
[49]
Cheng C, Teo K, Tan CS,et al.Myopic retinoschisis in Asians: Structural features and determinants of visual acuity and prognostic factors for progression[J].Retina,2016,36(4):717-726.
[50]
Baba T, Ohno-Matsui K, Futagami S,et al.Prevalence and characteristics of foveal retinal detachment without macular hole in high myopia[J].Am J Ophthalmol,2003,135(3):338-342.
[51]
Shimada N, Ohno-Matsui K, Yoshida T,et al.Progression from macular retinoschisis to retinal detachment in highly myopic eyes is associated with outer lamellar hole formation[J].Br J Ophthalmol,2008,92(6):762-764.
[52]
Jo Y, Ikuno Y, Nishida K.Retinoschisis: a predictive factor in vitrectomy for macular holes without retinal detachment in highly myopic eyes[J].Br J Ophthalmol,2012,96(2):197-200.
[53]
Sun CB, Liu Z, Xue AQ,et al.Natural evolution from macular retinoschisis to full-thickness macular hole in highly myopic eyes[J].Eye (Lond),2010,24(12):1787-1791.
[54]
Hattori K, Kataoka K, Takeuchi J,et al.Predictive factors of surgical outcomes in vitrectomy for myopic traction maculopathy[J].Retina,2018,38(Suppl 1):S23-S30.
[55]
Gaucher D, Haouchine B, Tadayoni R,et al.Long-term follow-up of high myopic foveoschisis: natural course and surgical outcome[J].Am J Ophthalmol,2007,143(3):455-462.
[56]
Kumagai K, Furukawa M, Ogino N,et al.Factors correlated with postoperative visual acuity after vitrectomy and internal limiting membrane peeling for myopic foveoschisis[J].Retina,2010,30(6):874-880.
[57]
Gui J, Ai L, Huang T.Vitrectomy with or without internal limiting membrane peeling for myopic foveoschisis[J].BMC Ophthalmol,2020,20(1):83.
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