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Pseudomacula is a kind of fundus disease, and the macular part of the fundus is a macular perforation, that is to say, the vitreous humor is not completely separated from the retina after the change, so the retina is pulled apart, forming a small hole, which is also a phenomenon of incomplete aging. It is common in older people and people who have had eye trauma or high myopia. Don't be afraid if you have macular hole, the macular hole is mainly based on the condition, if the tear condition is stable, you can not do any treatment; Those who are not accompanied by net release should be closely observed; Surgery for those with mesh detachment**.
For those who have a tendency to detach the net, argon laser** is given to seal the hole and prevent the detached net.
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Macular holes. Refers to the macular retina.
Full-thickness defect of the neuroepithelium. In 1869, it was reported by KNAPP and the name macular hole was proposed, and it was believed that it was related to trauma, and there was no effective method. In the early 70s, macular hole electrocoagulation, condensation and silicone cushion pressure were used, but due to the large damage to the macula, this surgical method was gradually eliminated.
In 1988 GASS proposed vitreous.
Posterior cortical tangent.
Traction doctrine. In the 90s, vitreous surgery plus inner limiting membrane exfoliation and the application of biological adjuvants**Macular hole and advanced examination equipment such as optical coherence tomography (OCT), retinal tomography (HRT), retinal thickness analyzer (RTA) have provided a broad prospect for the diagnosis of macular hole.
1. Anatomical characteristics of the macula.
The macula is about the size of the macular and is located on the temporal side of the optic disc, below the center line of the optic disc. Macular area.
It can be divided into several areas: the fovea centralis is located in the macula**, which is a place that descends from the surface of the retina and is about or, with a halo-like halo visible under the ophthalmoscope equivalent to the foveal edge. The foveola is in the foveola, about in diameter.
The central point (umbo) is in the fovea, and light is visible under the ophthalmoscope.
The point name is macular center reflection. The parafoveal area has a wide halo around the fovea, which is the thickest because of the retinal ganglion cells, the inner kernel layer, and the outer reticulum of the heale. The peri-foveal area is a wide ring area around the periphery of the parafovea.
2. Clinical manifestations of macular hole-MH.
1. Symptoms: Significant decrease in central vision, visual acuity is usually or worse, visual distortion, central scotoma. The main reasons are the absence of retinal photoreceptor cells at the hiatus, shallow detachment of the retina around the hiatus, cystoid edema around the hiatus, and varying degrees of retinal degeneration around the hiatus.
2. Fundus: There is a round or oval retinal defect in the macula area, which is dark red and has a clear border, generally less than 1PD, and the base may have yellow-white punctate punctation, and the light of the three-sided mirror slit lamp is interrupted.
3. Fundus fluorescence angiography (FFA): strong fluorescence consistent with the size of the hiatus can be seen in the macular area of the arterial phase, without leakage, without diffusion, and dissipates with the dissipation of background fluorescence. Typical"Defective window specimens"Alterations, which occur mainly due to atrophy of the retinal pigment epithelium.
4. Optical coherence tomography (OCT): the use of low-coherence light.
Obtain high-resolution cross-sections of living tissue within the eye. Macular hole is manifested as macular neuroepithelial loss, which is a full-thickness macular hiatus if the neuroepithelial is lost, and macula lamellar hiatus if the neuroepithelial part is missing.
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Macular hole refers to a tissue defect from the inner boundary membrane of the macular retina to the photoreceptor cell layer, which severely impairs the patient's central vision. Traumatic macular retinal tears were first reported by KNapp and Noyes in 1869 and 1871, respectively, and non-traumatic macular holes were first reported by Kuhnt in 1900. The prevalence of the disease is not high, accounting for about half of the population, with idiopathic macular hole of unknown origin being the most common (about 83%), and it usually occurs in healthy women over 50 years of age (average age 65 years, female:
Male = 2:1), 6% of patients with both eyes 28%. It also occurs in younger patients.
Classification of diseases 1Classification according to**: (1) Idiopathic macular hole.
2) Traumatic macular hole. (3) Macular hole with high myopia. (4) Secondary macular hole.
2.According to the morphology of the macular hole (1) Full-thickness macular hole. (2) Laminar macular holes.
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We know that the reason for the occurrence of macular hole is often caused by the traction of the epimacular membrane, if there is proliferative vitreoretinopathy, it is also prone to macular traction, and it is also easy to appear macular hole at this time, so if there are these high-risk factors, we must be alert to the appearance of macular hole, if there is a macular epimembrane, then vitrectomy combined with membrane peeling surgery is generally required.
Macular hole is divided into lamellar macular hole and full-thickness macular hole, the symptoms are still more obvious after the macular hole, there is often a decrease in central vision, abnormal color vision and deformation of sight, at this time, do not be careless, we must improve the examination of macular OCT, but also need to improve the examination of vision, intraocular pressure and fundus, if surgery is required, it must be carried out as soon as possible, do not delay the best time, Otherwise, the damage to the eyes is still relatively large.
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What is pseudomacular hole, the noun explanation definition is
That's the right question.
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1.Full-thickness macular hiatus.
The edge of the yellow zone hiatus is sharp, the light tangent is interrupted or dislocated under the pre-lens under the slit lamp, the patient can be aware of the light interruption by looking at the light, there is halo or localized retinal detachment around the hole, there may be yellowish-white dots at the bottom of the hole, and a semi-transparent operculum can be seen in typical patients, which is adherent to the locally thickened posterior vitreous cortical interface. The OCT image shows a full-thickness defect in the retinal neuroepithelial light band in the macular area.
2.Macular lamellar hiatus.
The edge of the hiatus is clear, and the light tangent is thinner under the pre-lens under the slit lamp, but there is no interruption or dislocation, and the patient does not feel that the light is interrupted, and there is no halo around the hole, only bright reflection. The OCT image shows a partial defect in the light band of the retinal neuroepithelium in the macular area.
3.Pseudopores in the macula.
Epiretinal membrane formation thickens the retina and piles up toward the center, which resembles a macular hole under ophthalmoscope or fundus color photography, but appears as a steep fovea on OCT images, and the retinal neuroepithelial light band is intact.
4.Macular cystoid degeneration.
When a small cyst rupture to form a large cyst, there may be macular hole-like changes under the ophthalmoscope, but OCT images can clearly show intact retinal tissue and cyst formation.
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1.Symptom. The onset of the disease is insidious, the course progresses slowly, and is sometimes detected when the other eye is covered.
In the early stage, it can be asymptomatic, and common symptoms include decreased vision and distorted vision. Visual acuity often drops to unequal, with an average of . The Amsler grid table can be used to detect visual distortion and central scotomas.
2.Fundus examination.
Ocular changes in idiopathic macular holes are mainly found in the macula of the fundus. Most cases are accompanied by incomplete or complete posterior detachment of the vitreous. In addition, because it occurs more often in the elderly, there are often varying degrees of lens opacity or lens nucleus sclerosis.
Fundus manifestations vary from one period to another. In the early stage, only yellow spots and yellow rings are seen in the macular area before the hiatus is formed, and sometimes vitreous traction and preretinal jujube membranes are present. After the disease progresses, a macular hole is formed, and the base is a dark red round hole under the ophthalmoscope, which can also be half-moon or horseshoe-shaped, and the diameter varies but is mostly 1 4 1 2 pd.
If cystoid edema is present around the finch foramen of the cleft stool, it may present as a halo at the edge of the foramen. In the late stages, there is posterior vitreous detachment or with a free lid.
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(1) Idiopathic macular hole.
2) Traumatic macular hole.
(3) Macular hole with high myopia.
4) Secondary macular hole (1) Full-thickness macular hole.
(2) Laminar macular holes.
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