Edward S Harkness Eye Institute, Columbia University Medical Center, Department of Ophthalmology, New York, NY 10032, USA.
Eye (Lond). 2012 Apr;26(4):494-500. doi: 10.1038/eye.2011.354. Epub 2012 Jan 13.
We report the diagnosis and treatment of patients with retinal detachment and/or retinoschisis associated with optic nerve coloboma or morning glory syndrome. A retrospective review of patients with optic nerve coloboma or morning glory syndrome with associated retinal detachment or retinoschisis was conducted. For five patients (six eyes), we report the clinical findings, spectral domain optical coherence tomography (OCT) imaging, intraoperative findings, and treatment outcomes. OCT scans demonstrate a bilaminar structure of maculopathy, consisting of inner schisis-like changes and outer layer retinal detachment. In most cases, a retinal break was demonstrated within the optic disc defect with three-dimensional OCT imaging. Glial tissue was sometimes observed within the anomalous defect. Vitrectomy and resection of the tractional tissue in these cases produced good anatomical and visual outcomes. Retinal detachment spontaneously resolved in cases where traction was not present. Traction may contribute to the pathogenesis of retinal detachment associated with colobomatous optic disc anomalies, either directly or by creating a secondary retinal break. OCT imaging assists with understanding the contributing factors to retinal detachment in individual cases of colobomatous optic disc anomalies and can thereby assist with determining the most effective approach to management.
我们报告了与视神经脑回样畸形或牵牛花综合征相关的视网膜脱离和/或视网膜劈裂患者的诊断和治疗。对伴有视网膜脱离或视网膜劈裂的视神经脑回样畸形或牵牛花综合征患者进行了回顾性研究。对于五名患者(六只眼),我们报告了临床发现、频域光学相干断层扫描(OCT)成像、术中发现和治疗结果。OCT 扫描显示黄斑病变呈双层结构,包括内部分层样改变和外层视网膜脱离。在大多数情况下,三维 OCT 成像显示在视盘缺损内存在视网膜裂孔。在异常缺损内有时可以观察到神经胶质组织。在这些情况下,玻璃体切除术和牵引性组织切除产生了良好的解剖和视力结果。在没有牵引的情况下,视网膜脱离会自行缓解。牵引可能通过直接作用或形成继发性视网膜裂孔,导致与脑回样视神经异常相关的视网膜脱离。OCT 成像有助于了解脑回样视神经异常患者视网膜脱离的促成因素,从而有助于确定最有效的治疗方法。