[关键词]
[摘要]
退行性视网膜劈裂(RS)是一种常见的周边视网膜变性疾病,多数患者无明显临床症状,病程较为良性,但其在形态学上与孔源性视网膜脱离(RRD)相似,而二者的治疗原则与预后截然不同,因此准确鉴别具有重要临床意义。近年来,多模态影像技术的进展为退行性RS的精确诊断与鉴别提供了有力支持,其中谱域OCT(SD-OCT)被公认为鉴别的金标准。当RS进展为进行性、症状性劈裂相关性视网膜脱离(PSSRD)时,需手术干预以挽救视功能,常用术式包括巩膜扣带术、玻璃体切除术或联合手术。在临床实践中,应根据患者具体病情制定个体化治疗策略,合理选择手术方式。文章旨在系统综述退行性RS及其并发症的自然病程、影像学特征与手术治疗等方面的最新研究进展,以期为临床诊疗提供参考。
[Key word]
[Abstract]
Degenerative retinoschisis(RS)is a common peripheral retinal degeneration that typically remains asymptomatic and follows a benign clinical course. However, its morphological resemblance to rhegmatogenous retinal detachment(RRD)presents a diagnostic challenge, as the two conditions demand fundamentally different management and carry distinct prognoses. Precise differentiation is therefore clinically imperative. Recent advances in multimodal imaging have substantially refined the diagnostic accuracy and differential assessment of degenerative RS, establishing spectral-domain optical coherence tomography(SD-OCT)as the definitive reference standard. When the disease progresses to progressive symptomatic schisis-related retinal detachment(PSSRD), prompt surgical intervention, including scleral buckling, pars plana vitrectomy, or a combined approach, is mandated to preserve visual function. Clinical decision-making must be individualized, with the surgical strategy carefully tailored to the specific characteristics of eachcase. This review provides a systematic synthesis of current evidence on the natural history, imaging hallmarks, and surgical management of degenerative RS and its complications, aiming to inform and optimize clinical practice.
[中图分类号]
[基金项目]
三晋英才医疗卫生领军人才项目(No.SJYC2024201)