Abstract: the degree of myopia exceeds 600 degrees (-6.0D) or axial length of more than 26mm, known as high myopia, in some patients, myopia and eyeball length will increase throughout life. The myopia of individual patients will exceed 2000 degrees, and the axial length of the eye exceeds 33mm. The change of modern lifestyle not only increases the incidence rate of serious systemic diseases such as diabetes, hypertension, heart disease, but also increases the incidence of severe diseases. It is gradually affecting people’s visual health. The fine division of labor in the way of life and work makes many of us work outdoors into indoor work, while the pressure on students to enter school increases year by year. Computer television has also become the main entertainment for most people. The reduction of urban green space also greatly reduces the time of outdoor sports, and the incidence of myopia is higher and higher., The degree of myopia exceeds 600 degrees (- 6.0d) or if the axial length exceeds 26mm, it is called high myopia. In some patients, the degree of myopia and eye length will continue to increase throughout their life. The degree of myopia of individual patients will exceed 2000 degrees and the axial length will exceed 33mm. Research shows that the probability of glaucoma, cataract and retinal detachment in high myopia is higher than that in normal eyes, but a considerable part of them Patients with high myopia, especially those with myopia greater than 1000 degrees, do not find very clear abnormal changes in various routine ophthalmic examinations, but they can’t get good corrected vision. Why?, With the emergence of a new generation of examination instruments, ophthalmologists are gradually solving this mystery. In recent years, a new inspection technology called optical coherence tomography (OCT) has emerged in ophthalmology clinic. This technology uses laser to scan the retina and can obtain cell-level retinal images. Therefore, it reveals the reason for the decline of vision in high myopia, that is, there are all kinds of “cracks” in the retina in high myopia., The retina covers the inner surface of the rear half of the eye and is more like a “bowl”. If the hole occurs at the front edge of the “bowl”, the impact on vision is not obvious, while the retina at the bottom of the “bowl” is used to form keen vision. Its central part is called macula, which is the anatomical part of the retina that forms keen vision and color perception, It is very important for the formation of vision. Once this part of the retina is “cracked”, even very small lesions will significantly affect vision., In the clinical OCT examination of macular hole in high myopia, we found that the retinopathy in the “bowl bottom” of the posterior pole mainly has the following forms: the first is macular hole, which forms a hole in the retina of the macula, which runs through the whole layer of the retina. The appearance of macular holes can be very sudden or slow, but there is usually a process of rapid vision decline and visual object deformation. Patients usually have clear complaints, such as “bending in the straight line”, “bending in the middle of the pole”, etc., and the visual power also drops rapidly below 0.1. If the vitreous fluid enters the retina through the retinal hole, retinal detachment will be formed, and the visual acuity will drop sharply, so that only human shadow can be seen, or even whether light exists., At present, another change of high myopia macular is increasingly attracting the attention of ophthalmologists, that is, high myopia macular splitting. Cleavage, as the name suggests, is the “cleavage” between the anatomical levels of the retina. This split does not run through the whole layer of the retina, but along a certain layer of the retina. Macular splitting occurs very slowly. Patients can have a slow decline in vision for many years and rarely attract attention. In clinical examination, it is often difficult for ophthalmologists to observe because the lesions are extremely subtle. Only in the examination of OCT scan can we find the existence of macular splitting., So in the eyes of high myopia, how do macular holes and macular splitting form? There is no doubt that the increasing degree and eye length of high myopia are the culprits, and the root cause is that the extension speed of retina can not catch up with the extension speed of eye shell. The retina is a nerve tissue, which is basically in a “stable” state in adulthood. Although it has a certain degree of softness and ductility, the degree is limited. The choroid, the outer tissue closely adhered to it, is a layer of vascular tissue. The sclera of the ocular shell tissue outside the choroid is also in the process of continuous extension and thinning, thus forming a “relative deficiency” of the retinal tissue in the eyeball. In the eyes of high myopia, the relatively insufficient retina is fighting against the expanding spherical wall. There are no more than three kinds of results: retinal hole, retinal detachment or retinal splitting. These pathological changes mainly occur in the macular region of high myopia, which seriously affects vision., The change of modern lifestyle of
not only increases the incidence rate of serious systemic diseases such as diabetes, hypertension, heart disease, but also gradually affects people’s visual health. The fine division of labor in the way of life and work makes many of us work outdoors into indoor work, and the pressure on students to enter school increases year by year. Computer TV has also become the main entertainment mode of most people. The reduction of urban green space also greatly reduces the time of outdoor sports, and the incidence of myopia is higher and higher.
myopia exceeds 600 degrees (- 6.0d) or if the axial length exceeds 26mm, it is called high myopia. In some patients, the degree of myopia and eye length will continue to increase throughout their life. The degree of myopia of individual patients will exceed 2000 degrees and the axial length will exceed 33mm. Research shows that the probability of glaucoma, cataract and retinal detachment in high myopia is higher than that in normal eyes, but a considerable part of them Patients with high myopia, especially those with myopia greater than 1000 degrees, did not find very clear abnormal changes in various routine ophthalmic examinations, but they could not obtain good corrected vision. Why?
with the emergence of a new generation of examination instruments, ophthalmologists are gradually solving this mystery. In recent years, a new inspection technology called optical coherence tomography (OCT) has emerged in ophthalmology clinic. This technology uses laser to scan the retina and can obtain cell-level retinal images. Therefore, it reveals the reason for the decline of vision in high myopia, that is, there are all kinds of “cracks” in the retina of high myopia。 The
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retinas cover the inner surface of the back half of the eyeball and are more like a “bowl”. If the hole occurs at the front edge of the “bowl”, the impact on vision is not obvious, while the retina at the bottom of the “bowl” is used to form keen vision. The heart part is called macula, which is the anatomical part of the retina that forms keen vision and color perception, It is very important for the formation of vision. Once this part of the retina is “cracked”, even very small lesions will significantly affect vision.
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in clinical OCT examination of macular hole in high myopia, we found that the retinopathy in this part of the “bowl bottom” of the posterior pole mainly has the following forms:
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are macular hole first, that is, a hole is formed in the retina of the macula, which runs through the whole layer of the retina. The appearance of macular holes can be very sudden or slow, but there is usually a process of rapid vision decline and visual object deformation. Patients usually have clear complaints, such as “bending in the straight line”, “bending in the middle of the pole”, etc., and the visual power also drops rapidly below 0.1. If the vitreous fluid enters the retina through the retinal hole, retinal detachment will be formed, and the vision will drop sharply. Only human shadows can be seen, and even the existence of light can be distinguished.
at present, another change of high myopia macular is increasingly attracting the attention of ophthalmologists, that is, high myopia macular splitting. Cleavage, as the name suggests, is the “cleavage” between the anatomical levels of the retina. This split does not run through the whole layer of the retina, but along a certain layer of the retina. Macular splitting occurs very slowly. Patients can have a slow decline in vision for many years and rarely attract attention. In clinical examination, because the lesions are very subtle, ophthalmologists are often difficult to observe, and only in the examination of OCT scan can we find the existence of macular splitting.
then in the eyes of high myopia, how do macular holes and macular splitting form? There is no doubt that the increasing degree and eye length of high myopia are the culprits, and the root cause is that the extension speed of retina can not catch up with the extension speed of eye shell. The retina is a nerve tissue, which is basically in a “stable” state in adulthood. Although it has a certain degree of softness and ductility, the degree is limited. The choroid, the outer tissue closely adhered to it, is a layer of vascular tissue. The sclera of the ocular shell tissue outside the choroid is also in the process of continuous extension and thinning, thus forming a “relative deficiency” of the retinal tissue in the eyeball. In the eyes of high myopia, the relatively insufficient retina is fighting against the expanding spherical wall. There are no more than three kinds of results, that is, retinal hole, retinal detachment or retinal splitting. These pathological changes mainly occur in the macular region of high myopia and seriously affect vision.
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understand the causes of retinal rupture in high myopia. By analyzing the anatomical characteristics of the retina, the solution came into being, that is to make the retina “softer”. By analyzing the characteristics of various levels of retinal tissue structure, it is found that the “inner limiting membrane” at the innermost level of the retina does not undertake the transmission process of retinal bioelectric signals in terms of structural characteristics, and its surface is often the main attachment site of proliferative tissue on the surface of the retina. If this layer of tissue membrane is removed, can the purpose of loosening the retina be achieved? The actual operation process of
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is several times more delicate than embroidery. Under the operating microscope magnified dozens of times, the doctor uses special instruments and vitreous surgery to combine a layer of transparent tissue on the inner surface of the retina in the macular region of high myopia with its surface proliferative membrane tissue, which is a membrane thinner than the diameter of a single cell, A doctor’s operation requires not only a high degree of concentration, but also great patience and good judgment. The results of
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are very satisfactory. After the operation, the patient fills the eyes with gas or silicone oil and maintains a prone position for a period of time. Under the top pressure of these filling substances, the retinal tissue is gradually restored. These changes can not only be verified by OCT, but also the patient can recover considerable vision, It shows that a considerable part of macular retinopathy of high myopia can be solved by retinal release surgery. This has been verified not only in theory, but also in practice. The success of the operation not only brings light to the patients, but also brings greater confidence to the ophthalmologists to overcome the problem of high myopia.