黃斑變性(1)

簡介:

       黃斑變性為黃斑區結構的衰老性改變。主要表現為視網膜色素上皮細胞對視細胞外節盤膜吞噬消化能力下降,結果使未被完全消化的盤膜殘余小體潴留于基底部細胞原漿中,并向細胞外排出,沉積于Bruch膜,形成玻璃膜疣。因此繼發病理改變后,導致黃斑變性發生,總之主要與黃斑區長期慢性光損傷,脈絡膜血管硬化,視網膜色素上皮細胞老化有關,由此繼發的種種病理改變后,則導致黃斑部變性發生。

分類:

       分為年齡相關性黃斑變性和少年黃斑變性兩種:年齡相關性黃斑變性,也稱老年黃斑變性(AMD)。本病大多發生于45歲以上,其患病率隨年齡的增長而增高,是當前中老年人致盲的重要疾病。

臨床表現:

       臨床表現 本病分萎縮性與滲出性兩型已如前述,也有人觀察到萎縮性可以轉化成滲出性,因此認為有分型的必要。然而就大多數病例來說,臨床表現輕重與預后優劣二型是截然不同的。

治療及預防

1、預防為主,早期治療

       黃斑變性,黃斑區玻璃疣是在本病病程的最早期階段,病變最輕,但它潛伏的危險性很大,此時最不可麻痹大意。少年黃斑變性的患者,早期中心視力有所下降,但眼底改變不明顯,此時應及時發現早期用藥,堅持治療。在任何疾病的過程中,病程最早期,病變最輕階段,都是最好的治療時機,有更多的機會阻止病程進展。

2、急重病例,標本共治

       當黃斑區出現血性色素上皮脫離,神經上皮脫離以及積血進入玻璃體,是病程急劇進展,視功能嚴重受損的征象,這種病例常反復發作,直至視力嚴重損傷或完全喪失。對于這種嚴重病例,必須全力積極治療,我們會根據病情的不同階段,運用不同的治療方法。

魏氏中醫眼科運用中醫藥治療黃斑變性具有很大優勢以下為舉例說明

       

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