Massachusetts Eye & Ear Infirmary, Boston, Massachusetts.
Massachusetts Eye & Ear Infirmary, Boston, Massachusetts.
Am J Ophthalmol. 2011 Sep;152(3):413-419.e6. doi: 10.1016/j.ajo.2011.02.012. Epub 2011 Jun 25.
To characterize the morphology of outer retinal holes caused by solar maculopathy, using spectral-domain optical coherence tomography (SD-OCT).
This study is an observational case series.
The SD-OCT findings of 3 patients (6 eyes) with chronic solar maculopathy are presented.
SD-OCT demonstrates a characteristic appearance of partial-thickness hole(s) in the outer retina at the fovea. In 3 of 6 eyes, there is 1 hole directly beneath the umbo. In the remaining 3 eyes, there are multifocal holes spread across the fovea. Holes in more restricted layers, as had been previously reported with time-domain OCT, were not seen. In addition, advanced visualization of SD-OCT data demonstrates a hyperreflective ring around the outer retinal hole.
SD-OCT can be used diagnose solar maculopathy. In patients with central scotomas, characteristic outer retinal hole(s) without inner retinal cystic changes may prompt the clinician to uncover an undisclosed history of sungazing. Similar OCT findings can be caused by welder's maculopathy, tamoxifen retinopathy, juxtafoveal macular telangiectasia, foveolar vitreomacular traction, or, rarely, a closed macular hole, achromatopsia, alkyl nitrite abuse, acute retinal pigment epitheliitis, or Stargardt disease.
利用频域光相干断层扫描（SD-OCT）对太阳性黄斑病变引起的视网膜外层孔的形态进行特征描述。
本研究为观察性病例系列研究。
呈现 3 名（6 只眼）慢性太阳性黄斑病变患者的 SD-OCT 发现。
SD-OCT 显示出黄斑区视网膜外层部分厚度孔的特征性表现。在 6 只眼中的 3 只眼中，有 1 个孔直接位于黄斑下。在其余 3 只眼中，有多个孔散布在黄斑区。如先前在时域 OCT 报道的那样，在更受限的层中没有看到孔。此外，SD-OCT 数据的高级可视化显示出外视网膜孔周围的高反射环。
SD-OCT 可用于诊断太阳性黄斑病变。在有中心暗点的患者中，无内层囊性改变的特征性外层孔可能提示临床医生发现未公开的太阳凝视史。类似的 OCT 发现也可能由焊工黄斑病变、他莫昔芬视网膜病变、黄斑旁毛细血管扩张、黄斑区中心凹玻璃体视网膜牵引、或罕见的闭合性黄斑孔、色盲、亚硝酸酯滥用、急性视网膜色素上皮炎或 Stargardt 病引起。
