Milani Paolo, Pece Alfredo, Pierro Luisa, Seidenari Patrizio, Radice Paolo, Scialdone Antonio
Ospedale Fatebenefratelli-Oftalmico, Corso di Porta Nuova 23, Milan, Italy.
J Ophthalmol. 2010;2010:970580. doi: 10.1155/2010/970580. Epub 2010 Nov 30.
Background. Tilted disc syndrome (TDS) is a congenital anomaly characterized by "tilting" of the optic disc tipycally associated with myopic astigmatism, visual field defect, inferior staphyloma, and retinal pigment epithelium atrophy. Associated complications such as macular serous neuroretinal detachment are well described; however, ideal therapy for such complication is unknown. Methods. One interventional case report is hereby described. A patient affected by macular serous neuroretinal detachment-complicated tilted disk syndrome underwent a complete ophthalmic examination. Optical coherence tomography and fluorescein angiography were taken at baseline and at scheduled visits. Two intravitreal treatments of bevacizumab (avastin, 1.25 mg/0.05 mL) were performed at monthly interval. Results. At scheduled visit, one month after the second injection, OCT depicted persistence of neuroretinal detachment. Best-corrected visual acuity remain stable as well as metamorphopsia and functional discomfort. Conclusion. Clinical evidence of this brief interventional case report indicates that one patient affected by recent serous macular detachment-complicated TDS did not benefit from 2 consecutive monthly intravitreal Avastin treatments. Best-corrected visual acuity remained stable over a total observation period of 6 months.
背景。倾斜盘综合征（TDS）是一种先天性异常，其特征为视盘“倾斜”，通常伴有近视散光、视野缺损、下方巩膜葡萄肿和视网膜色素上皮萎缩。黄斑浆液性神经视网膜脱离等相关并发症已有详细描述；然而，针对此类并发症的理想治疗方法尚不清楚。方法。在此描述一例介入性病例报告。一名患有黄斑浆液性神经视网膜脱离合并倾斜盘综合征的患者接受了全面的眼科检查。在基线和定期随访时进行了光学相干断层扫描和荧光素血管造影。每月间隔进行两次玻璃体内注射贝伐单抗（阿瓦斯汀，1.25 mg/0.05 mL）治疗。结果。在第二次注射后一个月的定期随访中，光学相干断层扫描显示神经视网膜脱离持续存在。最佳矫正视力、视物变形和功能不适均保持稳定。结论。这份简短的介入性病例报告的临床证据表明，一名近期患有浆液性黄斑脱离合并倾斜盘综合征的患者未从连续两个月的玻璃体内注射阿瓦斯汀治疗中获益。在6个月的总观察期内，最佳矫正视力保持稳定。
