Surgical treatment in macular diseases, criteria for indication by new modulity for examinations, and evaluation on outcome of treatment.

在一些常见和严重的黄斑疾病中，对其病理生理、临床特点、诊断标准、治疗适应证、临床病程和转归进行了评估。多灶性后色素上皮病(MPPE)是中心性浆液性脉络膜视网膜病变的一种严重变异型，其表现为大泡性视网膜脱离。MPPE主要累及脉络膜毛细血管的高通透性，继发性损害视网膜色素上皮，导致脉络膜视网膜下渗漏。结论：1.对渗漏部位进行激光光凝治疗有效。葡萄膜渗出综合征的表现是大泡性视网膜脱离和环状脉络膜脱离的结合。没有视网膜下渗漏。巩膜厚实僵硬。在巩膜中，胶原纤维束排列不规则，蛋白多糖沉积在基质中。由于巩膜异常，眼内液体的跨巩膜流出受到损害。我们与…举行会议CT、MRI、B超、眼轴长度显示鞍区虹膜异常较多。巩膜下巩膜切除术是一种成功的治疗方法。术后10年的19只眼中，1型6只眼，小眼球11只眼，2型11只眼，正常大小、异常巩膜2只眼，3型2只眼，正常大小、正常巩膜。单眼渗出型老年性黄斑变性第二只眼。随访第二眼170只眼，12只眼(7%)发生脉络膜新生血管(CNV)，经Kaplan-Meier寿命表分析，1年累积发生率为0.6%，3年累积发生率为5.6%，5年累积发生率为12.3%。易感表现主要来自浆液性RPE脱离，而不是软性玻璃体。息肉状脉络膜血管病变：常见的表现为视网膜和/或视网膜后极的浆液性和出血性脱离。ICG血管造影显示分支血管网络伴有息肉状和动脉瘤样扩张。对35只眼进行了为期4年的评估，认为这是RPE下脉络膜新生血管的一个变种。较少

In some of frequently occurred and severe macular diseases, pathophysiology, clinical features, criteria for diagnosis, indication for treatment, clinical course, and outcome were eveluated.1. Multifocal posterior pigment epitheliopathy (MPPE) This is a severe variant of central serous chorioretinopathy and its manifestation is bullous retinal detachment. Primary involvement of MPPE is in hyperpermeability of the choriocapillaris, and the retinal pigment epithelium is secondarily damaged, then lead to subretinal leakage from the choroid. Laser photocoagulation to the leakage sites is effecitve treatment.2. Uveal effusion syndrome Manifestation is a combination of bullous retinal detachment and annural choroidal detachment. There is no subretinal leakage. The sclera is thick and rigid. In the sclera, collagen fiber bundles are irragularly arranged, and proteoglycans are deposited in the matrix. Transscleral outflow of the intraocular fluid is impaired due to scleral abnormality. We conf … More irmed abnormality of the selera by CT, MRI, ultrasound, length of ocular axis. Subscleral sclerectomy is successful treatment. Among 19 eyes for 10 years, 6 eyes in type 1 ; nanophthalmic eye, 11 eyes in type 2 ; normal sized, abnormal sclera eye, 2 eyes in type 3 ; normal sized, normal sclera eyes.3. The second eye in unilateral exudative age-related macular degeneration. 170 eyes of the second eyes followed, choroidal neovascularizations (CNV) were developed in 12 eyes (7%), and accumulation of incidence were 0.6% by 1 year, 5.6% by 3 years, and 12.3% by 5 years with Kaplan-Meier life table analysis. Predisposing findings were mostly from serous RPE detachment, not from soft drusen.4. Polypoidal choroidal vasculopathy.Serous and hemorrhagic detachment of the retina and/or RPE in the posterior pole are common manifestation. ICG angiography revealed branching vascular network with polypoidal and aneurysmal dilatations. 35 eyes for 4 years were eveluated, and suggested as a variant of choroidal neovascularization beneath the RPE. Less