特發(fā)性黃斑前膜的研究進(jìn)展
發(fā)布時(shí)間：2019-05-17 18:26
【摘要】：視網(wǎng)膜前膜是位于玻璃體與視網(wǎng)膜內(nèi)界膜之間的一層纖維細(xì)胞膜,發(fā)生在黃斑區(qū)的視網(wǎng)膜前膜稱(chēng)為黃斑前膜。黃斑前膜按照病因可分為特發(fā)性黃斑前膜和繼發(fā)性黃斑前膜。特發(fā)性黃斑前膜的確切發(fā)病原因和形成機(jī)制目前仍然不清,其中最廣泛被接受的理論是玻璃體后脫離引起的視網(wǎng)膜內(nèi)界膜損傷導(dǎo)致來(lái)自其下方的視網(wǎng)膜膠質(zhì)細(xì)胞和其他細(xì)胞遷移并在內(nèi)界膜上增殖形成黃斑前膜。黃斑前膜早期為半透明的薄膜,可以完全無(wú)癥狀,隨著前膜的發(fā)展增厚,膜收縮時(shí)引起黃斑結(jié)構(gòu)異常,最終導(dǎo)致患者視物變形和中心視覺(jué)功能下降。特發(fā)性黃斑前膜多發(fā)生在50歲以上人群,其發(fā)病率逐漸上升,發(fā)病年齡呈現(xiàn)年輕化趨勢(shì)。按照眼底鏡下的表現(xiàn),黃斑前膜可分為早期玻璃紙樣反光型和后期黃斑纖維增生型。黃斑纖維增生型黃斑前膜可引起淺層或全層視網(wǎng)膜皺褶、牽引、血管迂曲或擴(kuò)張,嚴(yán)重者可引起視網(wǎng)膜出血、滲出、血管異常、水腫和黃斑裂孔,導(dǎo)致進(jìn)一步的視力損害。光學(xué)相干斷層掃描、對(duì)比敏感度、視野檢查、眼底照相、多焦視網(wǎng)膜電圖和眼底熒光血管造影等客觀檢查技術(shù)常常被用于對(duì)黃斑前膜的診斷以及形態(tài)和功能變化的評(píng)估。因?yàn)楣鈱W(xué)相干斷層掃描檢查具有方便、無(wú)創(chuàng)、直觀和可重復(fù)性強(qiáng)等優(yōu)點(diǎn),所以在黃斑前膜的診斷、評(píng)估預(yù)后和術(shù)后隨訪(fǎng)中應(yīng)用越來(lái)越廣泛,成為黃斑前膜診斷的金標(biāo)準(zhǔn)。黃斑前膜的治療目前尚無(wú)統(tǒng)一標(biāo)準(zhǔn),主要的治療方法包括隨訪(fǎng)觀察、藥物和手術(shù)治療。近幾年,很多研究者在研究藥物治療黃斑前膜的方法,其中藥物溶解玻璃體術(shù)較為有前景。但是,手術(shù)治療仍是目前黃斑前膜最主要的治療方法。本文主要回顧了近年來(lái)黃斑前膜發(fā)病機(jī)制和治療的相關(guān)研究,探討特發(fā)性黃斑前膜的發(fā)病機(jī)制和治療的發(fā)展方向。
[Abstract]:The anterior retinal membrane is a layer of fiber membrane between vitreous and retinal inner limiting membrane. The anterior retinal membrane, which occurs in macular area, is called macular membrane. According to the etiology, the anterior macular membrane can be divided into Idiopathic macular membrane and secondary macular membrane. The exact cause and formation mechanism of Idiopathic macular membrane are still unclear. Among them, the most widely accepted theory is that the injury of retinal inner limiting membrane caused by posterior vitreous detachment leads to the migration of retinal glial cells and other cells from below it and the proliferation of retinal glial cells and other cells from the inner limiting membrane to form macular membrane. The anterior macular membrane is a translucent film in the early stage, which can be completely asymptomatic. With the development of the anterior membrane, the macular structure is abnormal when the membrane contract, and finally leads to the deformation of the visual object and the decrease of the central visual function of the patients. Most of the Idiopathic macular membrane occurred in the population over 50 years old, the incidence of which increased gradually, and the age of onset showed a younger trend. According to the fundus microscopic findings, the anterior macular membrane can be divided into early glass pattern reflective type and late macular fiber hyperplasia type. Macular fiber hyperplasia macular membrane can cause superficial or full layer retinal wrinkle, traction, vascular detour or dilatation, severe can cause retinal hemorrhage, exudation, vascular abnormalities, edema and macular hole, leading to further visual impairment. Objective techniques such as optical coherence tomography, contrast sensitivity, visual field examination, fundus photography, multifocal electroretinography and fundus fluorescein angiography are often used for the diagnosis of macular membrane and the evaluation of morphological and functional changes. Because optical coherence tomography has the advantages of convenience, noninvasive, intuitionistic and reproducibility, it is more and more widely used in the diagnosis, prognosis evaluation and postoperative follow-up of macular membrane, which has become the gold standard for the diagnosis of macular membrane. There is no unified standard for the treatment of macular membrane. The main treatment methods include follow-up observation, medicine and surgical treatment. In recent years, many researchers have been studying the treatment of macular membrane with drugs, among which drug dissolution vitreous surgery is more promising. However, surgical treatment is still the most important treatment of macular membrane. In this paper, the pathogenesis and treatment of macular membrane in recent years were reviewed, and the pathogenesis and treatment of idiopathic anterior macular membrane were discussed.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R774.5
本文編號(hào)：2479311
[Abstract]:The anterior retinal membrane is a layer of fiber membrane between vitreous and retinal inner limiting membrane. The anterior retinal membrane, which occurs in macular area, is called macular membrane. According to the etiology, the anterior macular membrane can be divided into Idiopathic macular membrane and secondary macular membrane. The exact cause and formation mechanism of Idiopathic macular membrane are still unclear. Among them, the most widely accepted theory is that the injury of retinal inner limiting membrane caused by posterior vitreous detachment leads to the migration of retinal glial cells and other cells from below it and the proliferation of retinal glial cells and other cells from the inner limiting membrane to form macular membrane. The anterior macular membrane is a translucent film in the early stage, which can be completely asymptomatic. With the development of the anterior membrane, the macular structure is abnormal when the membrane contract, and finally leads to the deformation of the visual object and the decrease of the central visual function of the patients. Most of the Idiopathic macular membrane occurred in the population over 50 years old, the incidence of which increased gradually, and the age of onset showed a younger trend. According to the fundus microscopic findings, the anterior macular membrane can be divided into early glass pattern reflective type and late macular fiber hyperplasia type. Macular fiber hyperplasia macular membrane can cause superficial or full layer retinal wrinkle, traction, vascular detour or dilatation, severe can cause retinal hemorrhage, exudation, vascular abnormalities, edema and macular hole, leading to further visual impairment. Objective techniques such as optical coherence tomography, contrast sensitivity, visual field examination, fundus photography, multifocal electroretinography and fundus fluorescein angiography are often used for the diagnosis of macular membrane and the evaluation of morphological and functional changes. Because optical coherence tomography has the advantages of convenience, noninvasive, intuitionistic and reproducibility, it is more and more widely used in the diagnosis, prognosis evaluation and postoperative follow-up of macular membrane, which has become the gold standard for the diagnosis of macular membrane. There is no unified standard for the treatment of macular membrane. The main treatment methods include follow-up observation, medicine and surgical treatment. In recent years, many researchers have been studying the treatment of macular membrane with drugs, among which drug dissolution vitreous surgery is more promising. However, surgical treatment is still the most important treatment of macular membrane. In this paper, the pathogenesis and treatment of macular membrane in recent years were reviewed, and the pathogenesis and treatment of idiopathic anterior macular membrane were discussed.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R774.5
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