Gopal Lingam
Medical and Vision Research Foundations; Sankara Nethralaya, 18, College Road, Chennai, India.
Curr Opin Ophthalmol. 2008 May;19(3):248-54. doi: 10.1097/ICU.0b013e3282fc2604.
This paper reviews current understanding of coloboma of the choroid, as evaluated clinically and using optical coherence tomography.
Studies of the margin of coloboma of the choroid with optical coherence tomography revealed several interesting features, including variability in transition from normal retina to intercalary membrane (gradual or abrupt), presence of subclinical retinal detachments, focal communications between the subretinal space and subintercalary membrane space in eyes with extra-colobomatous retinal detachments, and inward humping of the eye wall in some cases. Pathological studies have stressed the importance of the intercalary membrane and the margin of coloboma as barriers for occurrence of retinal detachments. Vitrectomy and silicone oil tamponade could correct these retinal detachments in a majority of cases.
Optical coherence tomography can provide insight into pathology at the margin of the coloboma. Coupled with knowledge from histopathological studies, this information can guide the management of retinal detachments secondary to coloboma of the choroid with a high degree of success.
本文回顾了目前对脉络膜缺损的认识,包括临床评估及光学相干断层扫描(OCT)评估。
利用光学相干断层扫描对脉络膜缺损边缘的研究揭示了几个有趣的特征,包括从正常视网膜到插入膜的过渡变化(渐进性或突然性)、亚临床视网膜脱离的存在、合并脉络膜缺损以外视网膜脱离的眼中视网膜下间隙与插入膜下间隙之间的局灶性交通,以及某些情况下眼壁的向内隆起。病理学研究强调了插入膜和缺损边缘作为视网膜脱离发生屏障的重要性。在大多数情况下,玻璃体切除术联合硅油填充可矫正这些视网膜脱离。
光学相干断层扫描可深入了解缺损边缘的病理情况。结合组织病理学研究的知识,这些信息能高度成功地指导脉络膜缺损继发视网膜脱离的治疗。