Takezawa Mikiko, Tetsuka Soichi, Kakehashi Akihiro
Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, Saitama, Saitama, Japan.
Clin Ophthalmol. 2011;5:245-8. doi: 10.2147/OPTH.S16891. Epub 2011 Feb 21.
We report the possible mechanism of development of cystoid macular edema (CME) in retinitis pigmentosa (RP) in the case of a 68-year-old woman with RP and CME in the right eye and resolving CME in the left eye. Spectral domain optical coherence tomography showed CME and posterior vitreoschisis in the nasal quadrant of the fundus without a posterior vitreous detachment (PVD). This vitreous pathology suggested bilateral thickening and shrinkage of the posterior vitreous cortex. In the right eye, CME was evident with no vitreofoveal separation. However, in the left eye, minimal change was seen in the CME associated with a focal shallow PVD over the fovea. The best-corrected visual acuity (BCVA) in the left eye increased to 0.3 from 0.15 7 years after the first visit. Tangential vitreous traction on the macula may have caused the CME in the right eye. The shallow PVD over the fovea might have released the tangential vitreous traction from the fovea, induced spontaneous resolution of the CME, and improved the BCVA in the left eye.
我们报告了一名68岁患有视网膜色素变性(RP)且右眼患有黄斑囊样水肿(CME)、左眼CME正在消退的女性患者中RP并发CME的可能发病机制。频域光学相干断层扫描显示,眼底鼻侧象限存在CME和玻璃体后脱离(PVD),但没有玻璃体后皮质增厚和收缩。这种玻璃体病变提示双侧玻璃体后皮质增厚和收缩。在右眼,CME明显,无玻璃体黄斑分离。然而,在左眼,与黄斑区局灶性浅PVD相关的CME变化最小。首次就诊7年后,左眼的最佳矫正视力(BCVA)从0.15提高到了0.3。黄斑区的切线方向玻璃体牵拉可能导致了右眼的CME。黄斑区的浅PVD可能解除了来自黄斑区的切线方向玻璃体牵拉,促使CME自发消退,并提高了左眼的BCVA。