以视物变形为首诊的视网膜脱离

J4 ›› 2011, Vol. 10 ›› Issue (2): 51-53.

以视物变形为首诊的视网膜脱离

大理学院附属医院，云南大理 671000

收稿日期:2010-01-08 出版日期:2011-02-15 发布日期:2011-02-15
作者简介:李才锐，副主任医师，主要从事玻璃体视网膜疾病研究.
基金资助:
云南省科技厅科研基金资助项目（KY419340）；大理学院科研基金资助项目（2005X7）

Differential Diagnosis of Retinal Detachment with the Initial Clinical Complains as Metamorphopsia

Affiliated Hospital of Dali University, Dali, Yunnan 671000, China

Received:2010-01-08 Online:2011-02-15 Published:2011-02-15

摘要/Abstract

摘要：

目的：分析以视物变形为首诊的视网膜脱离患者误诊原因及治疗效果。方法:回顾性分析2009年1月－2009年12月间67例
以视物变形首诊的患者。进行详细病史再询问、详细眼底检查、B超或造影后得出最后诊断并进行手术治疗。结果：67例（67眼）以视物变形首诊患者中视网膜脱离8例（8眼,11.9％），中心性浆液性脉络膜视网膜炎29例（29眼，43.3%），黄斑水肿（10眼,14.9%），老年性黄斑变性（20眼，29.9%）。8例视网膜脱离误诊为中心性浆液性脉络膜视网膜炎（n=4, 50%），视网膜色素变性（n=2, 25%），黄斑水肿（n=2, 25%）。8例视网膜脱离均进行了视网膜手术，术后B超复查视网膜平坦，术后矫正视力均好转（100%, P＜0.01）。结论:症状不典型的视网膜脱离容易被误诊，系统的眼部检查和详细鉴别诊断可减少误诊。

关键词: 视物变形, 视网膜脱离, 中心性浆液性脉络膜视网膜炎

Abstract:

Objective: To analyze the reasons of misdiagnose and therapeutic effects of patients with retinal detachment whose initial clinical complains were metamorphopsia. Method: A retrospective research was performed on 67 patients whose initial clinical complains were metamorphopsia from January 2009 to December 2009. The final diagnosis was achieved by history, careful fundus examination, ultrasonography and fluorescein fundus angiography test（FFA）, then all cases underwent an operation therapy. Results: There were 8 retinal detachment patients（11.9%）,29 central serous chorioretinopathy（43.3%）,20 macular edema（14.9%）and 20 age -related macular degeneration （29.9% ） in the 67 patients. Retinal detachment was misdiagnosed as central serous chorioretinopathy（n=4, 50%）,retinitis pigmentasia（n=2, 25%）and macular oedema（n=2, 25%）. All 8 retinal detachment patients were applied with retinal surgery. Post-operative ultrasonography showed flat retina; and 8 patients' post-operative corrected vision improved （100% , P ＜0.01）.Conclusion: Atypical retinal detachment is easy to be missed; misdiagnosis can be reduced by comprehensive eye examination and carefully differential diagnosis.

Key words: metamorphopsia, retinal detachment, central serous chorioretinopathy

中图分类号:

R774.1+3

李才锐, 孙曙光, 马麦聪, 吴锐锋, 马海智, 赵微. 以视物变形为首诊的视网膜脱离[J]. J4, 2011, 10(2): 51-53.

LI Cai-Rui, SUN Shu-Guang, MA Mai-Cong, WU Rui-Feng, MA Hai-Zhi, ZHAO Wei. Differential Diagnosis of Retinal Detachment with the Initial Clinical Complains as Metamorphopsia[J]. J4, 2011, 10(2): 51-53.