脈絡膜剝離之臨床研究

Clinical Studies on Choroidal Deachment

楊中美(Chung-May Yang) ； 李英麒(Ying-Chee Lee) ； 侯平康(Ping-Kang Hou) ； 劉寬鎔(Kwan-Rong Liu) ； 陳慕師(Muh-Shy Chen) ； 楊長豪(Chang-Hao Yang) ； 黃正賢(Jen-Shang Huang) ； 林昌平(Chang-Ping Lin)

《中華民國眼科醫學會雜誌》 34卷3期 (1995/09) Pp. 305-312

https://doi.org/10.30048/ACTASOS.199509.0002

摘要

脈絡膜剝離，滲出性或出血性，可今生於許多眼疾。為研究併發脈絡膜剝離之臨床疾病及評估脈絡膜剝離之存在或嚴重度對疾病預後之影響，我們回溯分析台大眼科自1988年1月至1994年6月經超音波診斷證實有脈絡膜剝離之病例共86例，疾病診斷包括1．眼外傷。2．裂孔性視網膜剝離。3．眼內手術引起之上脈絡膜出血或滲液。4．鞏膜扣壓術後。5．眼內腫瘤。6．眼內炎。7．眼球萎縮。
在眼外傷組中，36例中27例最終眼球萎縮。術前脈絡膜剝離進步與否及是否合併玻璃體出血和視網膜剝離與預後有統計上之相關。在裂孔性視網膜剝離組中23例中13例視網膜復位。在眼內手術引起之脈絡膜剝離組中，9例中5例視網膜復位。在鞏膜和壓術組中，兩例均有視網膜復位。在眼內炎組中，外因性感染之例均喪失眼球。眼內腫瘤之兩例分別為瀰漫性脈絡膜血管瘤及T細胞淋巴瘤。研究顯示脈絡膜剝離可發生淤多種情況下，有些是疾病嚴重度之指標，也可能作治療方式選譯之參考，是眼科重要之問題。

並列摘要

Choroidal detachment (CD), either serous or hemorrhagic, may occur in various intraocular disorders.
In order to study the clinical entities associated with CD and to evaluate how the prescence of CD and the severity of CD affect the prognosis, from 1988 to 1994, clinical charts and echographic files from patients with ultrasonographic evidence of CD were reviewed.
The diagnosis, the severity of CD, the nature of suprachoroidal content, the procedures performed and the visual changes were recorded. The extent of CD and its duration were correlated with visual outcome in different diseases. Important etiologies include eye trauma, rhegmatogenous retinal detachment combined with CD, expulsive or limited suprachoroidal hemorrhage, choroiditis, post-scleral buckling procedure, intraocular tumor.
In the trauma group, 27 in 36 cases went on to phthisis. Pre-operative CD improvement had positive correlation with good anatomical results. In the rhegmatogenous retinal detachment group, 13 out of 23 cases (57%) had reattachment of the retina. In the post intraocular surgeries group (cataract, glaucoma, penetrating keratoplasty), five out of nine cases had retinal attachment. In the post scleral buckling group, both cases had good anatomical result. In the intraocular inflammation group, three cases with infectious endophthalmitis ended up with enucleation. Choroidal detachment may be a major clinical menifestation in certain diseases, it may also be an important indicator of the disease severity and may be an important factor in deciding the timing and procedures of the treatment.

並列關鍵字

Choroidal detachment ； Retinal detachment ； Suprachoroidal hemorrhage