Karim-Zade Khakima, Bilgic Alper, Bartz-Schmidt Karl U, Gelisken Faik
Center for Ophthalmology, University of Tuebingen, Schleichstr. 12, 72076 Tuebingen, Germany.
Graefes Arch Clin Exp Ophthalmol. 2007 Aug;245(8):1221-3. doi: 10.1007/s00417-006-0508-y.
A macular hole can develop as a late complication secondary to a branch retinal vein occlusion (BRVO). We report about an atypical horseshoe-like tear occurring in the fovea after recurrent BRVO.
An interventional case report.
In 1997, a 53-year-old man was seen with an occlusion of macular part of inferior temporal vein of the retina on the left eye. After experiencing several recurrent BRVO in this eye, 6 years later he presented with a horseshoe-like tear in the fovea. Visual acuity was 20/200. The patient underwent standard three-port vitrectomy and installation of C3F8 16%. Intraoperatively, massive traction of the vitreous was detected on the edges of the tear. Six months after the operation, the tear remained attached. The visual acuity was 20/200.
The uniqueness of the presented case is the occurrence of a macular tear following recurrent BRVO, its horseshoe-like shape and foveal location. To the best of our knowledge, this is the first report on a horseshoe-like tear seen in the fovea secondary to BRVO. We assume that chronic macular edema and retinal ischemia following BRVO were additional factors beside the vitreous traction, contributing to the formation of the macular tear. Anatomical closure of the tear and stabilisation of visual acuity can be achieved by vitreoretinal surgery.
黄斑裂孔可作为视网膜分支静脉阻塞（BRVO）的晚期并发症出现。我们报告了一例复发性BRVO后在黄斑中心凹出现的非典型马蹄形裂孔。
一份介入性病例报告。
1997年，一名53岁男性因左眼视网膜颞下静脉黄斑部阻塞前来就诊。该眼经历多次复发性BRVO后，6年后他出现黄斑中心凹马蹄形裂孔。视力为20/200。患者接受了标准的三通道玻璃体切除术并注入16%的C3F8。术中，在裂孔边缘检测到玻璃体大量牵拉。术后6个月，裂孔保持附着状态。视力为20/200。
本病例的独特之处在于复发性BRVO后出现黄斑裂孔，其马蹄形形态及黄斑中心凹位置。据我们所知，这是第一例关于BRVO继发于黄斑中心凹马蹄形裂孔的报告。我们推测，BRVO后的慢性黄斑水肿和视网膜缺血是除玻璃体牵拉外导致黄斑裂孔形成的其他因素。玻璃体视网膜手术可实现裂孔的解剖学闭合和视力稳定。
