先天性瞳孔残膜（PPM）临床诊治分析（附7例病例报告）

发布时间：2019-01-03 07:09

【摘要】： [目的] 通过病例回顾,总结和分析瞳孔残膜的临床表现和治疗现状,探讨其发病机制,为临床上瞳孔残膜的早期诊断及制定个性化治疗方案提供依据。 [材料与方法] 统计2003年8月至2009年8月期间于浙江大学医学院附属第二医院眼科中心诊断为膜状瞳孔残膜的病例,对其病史进行回顾调查总结；查找美国国立医学图书馆PubMed1980年以后在线数据库,输入关键词(先天性瞳孔残膜、虹膜发育异常、白内障、青光眼、瞳孔异常),结合文献报道,全面剖析PPM发病机制、临床表现及治疗方法。 [结果] 2003年8月至2009年8月期间于浙江大学医学院附属第二医院眼科中心诊断为膜状瞳孔残膜的患者共7位(12只眼),其中4例(7只眼)合并白内障表现,1例(2只眼)合并青光眼、白内障表现,1例(1只眼)合并视网膜脱离表现。PubMed1980年以后查新结果中膜状瞳孔残膜病例少有报道,该疾病的发生与虹膜发育异常有关。【结论】 (1)PPM系胚胎期晶状体血管膜前部不完全消退所致的一种虹膜先天异常。 (2)PPM临床表现主要为瞳孔区颜色与虹膜相同的色素组织,可伴有白内障、青光眼、视网膜脱离等。 (3)目前治疗PPM的方法主要是保守治疗、激光治疗及手术治疗,需根据患者不同临床特点和病程制定个性化治疗方案。
[Abstract]:[objective] to summarize and analyze the clinical manifestation and treatment status of pupillary remnant by reviewing the cases, and to explore its pathogenesis, and to provide evidence for early diagnosis and individualized treatment of pupillary remnant membrane. [materials and methods] from August 2003 to August 2009, the patients diagnosed as the residual membrane of the membranous pupillary in the Eye Center of the second affiliated Hospital of Zhejiang University Medical College were retrospectively investigated and summarized. To find the online database of the National Library of Medicine (PubMed1980), input the key words (congenital pupillary remnant, iris dysplasia, cataract, glaucoma, pupil abnormality), and analyze the pathogenesis of PPM. Clinical manifestation and treatment. [results] from August 2003 to August 2009, there were 7 patients (12 eyes) diagnosed as membranous pupillary remnant membrane in the Eye Center of the second affiliated Hospital of Zhejiang University Medical College, of which 4 cases (7 eyes) were complicated with cataract. One case (2 eyes) was complicated with glaucoma, cataract and one case (1 eye) with retinal detachment. There were few cases of remnant membrane in the middle pupil after PubMed1980 years. The occurrence of this disease was related to abnormal iris development. [conclusion] (1) PPM is an iris congenital abnormality caused by incomplete regression of anterior vascular membrane of lens in embryonic phase. (2) the clinical manifestations of PPM were mainly the same color of the pupillary area as the pigmented tissue of the iris, which could be accompanied by cataract, glaucoma, retinal detachment and so on. (3) at present, conservative treatment, laser therapy and surgical treatment are the main methods for the treatment of PPM. Individualized treatment should be made according to the different clinical characteristics and course of the patients.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R77

【共引文献】