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[摘要]
飞蚊症作为眼科常见病,其病因复杂,涉及玻璃体结构与功能改变,与年龄、近视等因素密切相关,玻璃体液化和后脱离在其中起到关键作用。临床表现为眼前点线状黑影飘动,通常不会引起视力损害。既往受限于传统观念及治疗手段,常采取保守观察策略。然而,越来越多患者抱怨飞蚊症导致驾驶困难、阅读困难,严重影响视觉质量和心理健康,其治疗需求日益增加。现有的治疗方案各有利弊,药物治疗效果有限且存在争议,玻璃体切除术疗效确切但发生并发症的风险高; YAG激光玻璃体消融术相对安全,但疗效受限于混浊物大小、位置等因素; 纳米气泡介导的玻璃体消融术尚处在研究阶段,未来有望为患者提供更安全有效的治疗。文章综述飞蚊症的病因及其最新治疗进展,以期加深临床医生对于飞蚊症的认识,为临床诊疗提供更全面的科学依据,推动个性化、精准化的治疗。
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[Abstract]
As a common ophthalmic disease, floaters have a complex etiology. It involves changes in the structure and function of the vitreous body and is closely associated with factors like age and myopia. Vitreous liquefaction and posterior detachment play a crucial role in this regard. Clinically, patients usually experience the floating of dotted or linear black shadows in front of their eyes, and generally, floaters do not cause visual impairment. In the past, due to the limitations of traditional concepts and treatment methods, a conservative observation strategy was often adopted. However, an increasing number of patients have complained that floaters lead to difficulties in driving and reading, which seriously affects their visual quality and mental health. Consequently, the demand for treatment has been growing day by day. The existing treatment options each have their own advantages and disadvantages. The efficacy of drug treatment is limited and remains controversial. Vitrectomy has a definite curative effect, yet it comes with a high risk of complications. YAG laser vitreolysis is relatively safe, but its curative effect is restricted by factors such as the size and location of the opacities. Nanobubble-mediated vitreolysis is still in the research stage and is expected to offer patients safer and more effective treatment in the future. This article reviews the etiology of floaters and the latest progress in its treatment, aiming to deepen clinicians' understanding of floaters, provide a more comprehensive scientific basis for clinical diagnosis and treatment, and promote personalized and precise treatment.
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