Chen Ling, Wang Keyan, Esmaili Daniel D, Xu Gezhi
Eye and Ears, Nose, and Throat Hospital, Department of Ophthalmology, Fudan University, Shanghai, China.
Arch Ophthalmol. 2010 Dec;128(12):1551-4. doi: 10.1001/archophthalmol.2010.284.
To characterize posterior paravascular linear retinal breaks over areas of patchy chorioretinal atrophy as a cause of retinal detachment among patients with pathologic myopia.
In this retrospective case series, we evaluated 10 pathologically myopic eyes having rhegmatogenous retinal detachment associated with posterior paravascular linear retinal breaks.
Ten eyes with posterior paravascular linear retinal breaks and retinal detachment were identified from January 1, 2008, to July 31, 2009. The retinal breaks were most frequently found along the inferotemporal vascular arcade, followed by the superotemporal arcade. The length of the breaks ranged from 0.25 to 1 disc diameter, and their distance from the optic disc ranged from 1 to 5 disc diameters. These paravascular linear retinal breaks have distinct clinical characteristics, including a strong propensity to occur over areas of patchy chorioretinal atrophy, a linear shape that is oriented parallel to the adjacent retinal vessels, and a tendency to result in progressive retinal detachment. Vitrectomy with gas tamponade was performed in all cases, and retinal reattachment was achieved in 9 cases by a single operation.
Paravascular linear retinal breaks over areas of patchy chorioretinal atrophy represent a distinct clinical entity that can result in a special category of retinal detachment among patients with pathologic myopia. These breaks are apt to elude detection before surgery, and a careful search along the posterior vascular arcades during vitrectomy may help to detect these abnormalities. Pars plana vitrectomy with photocoagulation and intraocular tamponade may lead to a resolution of such rhegmatogenous retinal detachments.
明确病理性近视患者中，脉络膜视网膜片状萎缩区域上方的视网膜血管旁线性裂孔作为视网膜脱离病因的特征。
在这个回顾性病例系列研究中，我们评估了10只患有孔源性视网膜脱离且伴有视网膜血管旁线性裂孔的病理性近视眼睛。
在2008年1月1日至2009年7月31日期间，共识别出10只存在视网膜血管旁线性裂孔及视网膜脱离的眼睛。视网膜裂孔最常出现在颞下血管弓，其次是颞上血管弓。裂孔长度为0.25至1个视盘直径，与视盘的距离为1至5个视盘直径。这些视网膜血管旁线性裂孔具有独特的临床特征，包括在脉络膜视网膜片状萎缩区域上方极易出现、呈与相邻视网膜血管平行的线性形态，以及有导致视网膜脱离进展的倾向。所有病例均行玻璃体切除联合气体填充术，9例患者通过单次手术实现视网膜复位。
脉络膜视网膜片状萎缩区域上方的视网膜血管旁线性裂孔是一种独特的临床实体，可导致病理性近视患者出现特殊类型的视网膜脱离。这些裂孔在手术前容易漏诊，玻璃体切除术中仔细检查后血管弓可能有助于发现这些异常。玻璃体切除联合光凝及眼内填充术可能会使此类孔源性视网膜脱离得到治愈。
