以视物变形为首诊的视网膜脱离

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。

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

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.