Zweifel Sandrine A, Engelbert Michael, Laud Ketan, Margolis Ron, Spaide Richard F, Freund K Bailey
Vitreous Retina Macula Consultants of New York, 460 Park Ave, Fifth Floor, New York, NY 10022.
Arch Ophthalmol. 2009 Dec;127(12):1596-602. doi: 10.1001/archophthalmol.2009.326.
To describe tubular structures found in the outer retina seen in a variety of retinal disorders.
Sixty-nine eyes of 63 patients were examined with spectral-domain optical coherence tomography. Optical coherence tomography C-scans were correlated with their corresponding B-scans. The prevalence, number, size, and shape of the tubular structures were determined.
Branching tubules were identified in the outer retina of 54 patients with age-related macular degeneration and in 9 patients with other diagnoses. The tubules appeared as round or ovoid hyporeflective spaces with hyperreflective borders on the B-scans, measuring 40 to 140 microm high and 40 to 2260 microm wide. Morphologic features ranged from single straight or branching tubules to complex cavitary networks, usually overlying areas of pigment epithelial alteration or subretinal fibrosis. The tubules generally remained stable over time. In a retinal practice specializing in advanced age-related macular degeneration, these structures were identified in 60 of 248 patients (24.2%) seen during a 3-month period.
Degenerating photoreceptors may become arranged in a circular or ovoid fashion during a process we propose to term outer retinal tubulation. These changes are apparently common in advanced diseases affecting the outer retina and retinal pigment epithelium. This observation has practical implications because these findings can be misinterpreted as intraretinal or subretinal fluid, possibly prompting unnecessary interventions.
描述在多种视网膜疾病中于视网膜外层发现的管状结构。
对63例患者的69只眼进行了光谱域光学相干断层扫描检查。光学相干断层扫描C扫描与其相应的B扫描相关联。确定管状结构的患病率、数量、大小和形状。
在54例年龄相关性黄斑变性患者和9例其他诊断患者的视网膜外层发现了分支小管。在B扫描中，小管表现为圆形或椭圆形低反射区，边界为高反射，高度为40至140微米，宽度为40至2260微米。形态学特征范围从单一的直小管或分支小管到复杂的空洞网络，通常覆盖色素上皮改变或视网膜下纤维化区域。这些小管通常随时间保持稳定。在一家专门诊治晚期年龄相关性黄斑变性的视网膜诊所，在3个月期间就诊的248例患者中有60例（24.2%）发现了这些结构。
在我们提出称为视网膜外层管状化的过程中，退化的光感受器可能会以圆形或椭圆形排列。这些变化在影响视网膜外层和视网膜色素上皮的晚期疾病中显然很常见。这一观察结果具有实际意义，因为这些发现可能会被误判为视网膜内或视网膜下液，可能会引发不必要的干预措施。
