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病理性近视眼眼底改变

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早在几年前就听说师兄方严在编写一部有关近视眼的专著,他说中国是近视眼大国,近视人群已经超过3亿人,而专门从事近视眼防治的专科医师并不多,有关的著作更屈指可数,相当一部分还是科普书,质量良莠不齐,认真编写一部近视眼防治方面的专著是他的愿望之一。本以为也就是编本近视眼防治尤其是青少年近视防治的科普书吧,今天有幸接到他交给我的百余页20余万字的书稿,我还是惊奇万分!一口气通读全书,被它的内容深深吸引,也十分敬佩师兄为此所付出的心血!
首先,是立题为“病理性近视眼眼底改变”,众所周知,病理性近视眼虽然只占近视眼的0.1 %,在中国也已经超过1000万名患者,它已经超出屈光不正的范畴,是一种严重影响视力和患者生活质量的独立疾病,而影响视力的主要原因是其眼底病变!目前确实缺乏有关的著作。其次,《病理性近视眼眼底改变》对现代眼底影像技术在病理性近视眼眼底病变中应用进行了详细的总结,并积累了大量珍贵的图片资料,眼底彩像、OCT图像、眼底血管造影图像、超声图像等均包括在内,使《病理性近视眼眼底改变》图文并茂。再者,书中概念定义明确规范,条理清晰,无论对病理性近视眼的定义,还是眼底病变的分类和演变;无论是各种病变的描述,还是其发生机制与治疗预后的分析,均有自己的临床经验总结和独到的分析见解。还有,书中没有过多的理论与推理,紧扣临床,实用性很强,是一部易学好用的著作,相信会被广大眼科临床工作者和从事近视眼研究的学者们垂青!
Author Description

方严,男,汉族。1983年毕业于安徽医科大学,医学硕士,眼科研究员、主任医师、安徽理工大学眼科研究所所长,安徽医科大学、皖南医学院兼职教授、硕士生导师,淮南市第一人民医院眼科主任。中国医师协会眼科医师分会委员,安徽省眼科学会副主任委员,安徽省医学教育学会副主任委员,安徽医科大学主办《临床眼科杂志》常务副主编。从事眼科临床医疗、科研、教学工作30年。获安徽省科技进步二等奖1项、三等奖2项;地厅级科技进步一等奖1项、二等奖2项;中华眼科学会奖、安徽省青年科技创新奖及安徽青年科技奖获得者。主编、副主编学术著作8部,参编4部。发表眼科学术论文50多篇。安徽省卫生类学术和技术带头人。2010年被授予“安徽省杰出专业技术人才”称号。安徽省第九、第十届人大代表,安徽省第十届政协委员。
Catalogue

第一章 病理性近视眼的定义及有关规范化概念
第一节 概述
第二节 病理性近视眼的定义
第三节 病理性近视眼有关规范化概念

第二章 病理性近视眼眼底改变的分类及演变
第一节 眼底改变的演变规律:眼底改变的转归
第二节 存在于生理性和病理性近视眼的过渡型:中间性近视眼
第三节 中间性近视眼向病理性近视眼的演变

第三章 豹纹状眼底
第一节 豹纹状眼底发生机制
第二节 豹纹状眼底临床特征及分级
第三节 豹纹状眼底发生率
第四节 与其他近视性眼底改变关系
第五节 豹纹状眼底改变与后葡萄肿、脉络膜退变、巩膜扩张的关系

第四章 后葡萄肿
第一节 后葡萄肿定义与概念的规范
第二节 后葡萄肿发生机制
第三节 后葡萄肿分型及临床特征
第四节 后葡萄肿演变过程
第五节 后葡萄肿分级

第五章 视盘改变
第一节 视盘鼻侧牵引
第二节 视盘弧形斑
第三节 视盘倾斜与轴位
第四节 视杯改变
第五节 视盘视网膜血管改变

第六章 视网膜脉络膜改变
第一节 视网膜脉络膜改变(早期)——黄斑出血
第二节 视网膜脉络膜改变(早期)——漆裂纹样病变
第三节 视网膜脉络膜改变(早期)——局灶性萎缩
第四节 视网膜脉络膜改变(中晚期)——视盘周边退行性萎缩
第五节 视网膜脉络膜改变(中晚期)——弥漫性视网膜脉络膜萎缩
第六节 视网膜脉络膜改变(中晚期)——脉络膜新生血管
第七节 视网膜脉络膜改变(中晚期)——Fuchs斑

第七章 黄斑改变(综合)
第一节 黄斑色素紊乱
第二节 黄斑红变
第三节 黄斑局灶性萎缩
第四节 漆裂纹样病变
第五节 Fuchs斑
第六节 黄斑出血
第七节 视网膜下或脉络膜新生血管
第八节 黄斑囊样变性、黄斑裂孔及黄斑脱离
第九节 黄斑劈裂

第八章 周边眼底改变
第一节 弥漫性或局限性色素变性
第二节 非压迫自变性
第三节 铺路石样变性
第四节 格子样变性
第五节 囊样变性
第六节 视网膜裂孔及撕裂

第九章 玻璃体后脱离
第一节 玻璃体和视网膜界面的结构
第二节 病理性近视眼的玻璃体改变
第三节 玻璃体后脱离的发病机制与病程进展
第四节 玻璃体后脱离的分类和临床特征
第五节 玻璃体后脱离检查方法
第六节 玻璃体后脱离的并发症
第七节 玻璃体后脱离的治疗

第十章 病理性近视眼黄斑裂孔视网膜脱离
第一节 概述
第二节 病因及发病机制
第三节 临床特征
第四节 治疗及预后
中文索引
英文索引
Introduction

近视眼是世界性医学难题,也是眼科学界争论最多的领域之一。我国是近视眼患病大国,随着近视患病率的逐年增加,高度近视眼比例也在逐年增高,人群总数加大,且家族聚集性显著。国人近视人群超过3亿人,高度近视眼约占近视人群的5%~20%。高度近视眼视觉质量低,其中病理性近视眼是引起视网膜脉络膜病理改变的重要原因,日渐增多的高度近视眼和病理性近视眼人群对社会和家庭产生的负担越来越重。近视眼的防治不仅仅是医学问题,而且也是十分重要的公共卫生和社会学问题,关系到我国国民的健康素质。
近视眼中的病理性近视眼(pathological myopia)最重要、最多见的临床表现是眼底改变,虽然有些改变尚没有被彻底认识,但随着基础研究、现代检查方法及诊断技术的发展认识会不断加深。人类对近视眼的研究和争论已探索了100多年,对高度近视眼也早有认识,目前,越来越多的学者认为病理性近视眼不完全等同于高度近视眼,已超出了屈光不正的范畴,应视为一个独立的眼病。受Curtin所著《The Myopias》 -书的启发,我们结合自己工作中的临床研究资料并系统复习病理性近视眼相关文献,有意对病理性近视眼的眼底改变这一专题进行全面系统的阐述,旨在对病理性近视眼的研究者提供借鉴和参考。本书共十章,20余万字,插图400余幅。在眼底改变各章节的描述中,力求文字简练,图表随文而插,便于理解。书后备有中英文索引,可供查阅。

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