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儿童期发病与成年期发病视盘旁凹视网膜病变的对比性发现。

Comparative findings in childhood-onset versus adult-onset optic disc pit maculopathy.

机构信息

Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan.

出版信息

Acta Ophthalmol. 2013 Aug;91(5):429-33. doi: 10.1111/j.1755-3768.2012.02429.x. Epub 2012 May 2.

Abstract

PURPOSE

To compare the clinical characteristics of eyes with childhood-onset to those with adult-onset optic disc pit maculopathy.

METHODS

Twenty-seven eyes of 25 patients with optic disc pit maculopathy were reviewed. The clinical characteristics, clinical history including a history of blunt trauma, ophthalmoscopic evaluations and intraoperative findings in the childhood-onset (age <15 years, four eyes of four patients) cases were compared with those in the adult-onset (≥15 years, 23 eyes of 21 patients) cases of optic disc pit maculopathy. The strength of the vitreous adhesions was graded by what was required to create a posterior vitreous detachment (PVD); grade 1 = with vitreous cutter, grade 2 = by microhook or forceps and grade 3 = by forceps with removal of remnants of Cloquet's canal.

RESULTS

The incidence of visual impairments following blunt trauma was significantly higher in childhood-onset (three of four eyes) than that of adult-onset (0 of 23 eyes, p = 0.0014). Vitreous surgery with creation of a PVD was performed in the four childhood-onset eyes and 18 adult-onset eyes after an absence of a spontaneous resolution. The grade of the vitreous adhesions was significantly higher in childhood-onset than in adult-onset eyes (p = 0.0096).

CONCLUSIONS

An ocular trauma may provide an opportunity to detect optic disc pits. However, childhood-onset optic disc pit maculopathy was noted most commonly following blunt ocular trauma in eyes with a strong vitreous adhesion to the optic disc margin.

摘要

目的

比较儿童期发病和成年期发病视盘小凹伴黄斑病变眼的临床特征。

方法

回顾了 25 例视盘小凹伴黄斑病变患者的 27 只眼。比较了儿童期(年龄<15 岁,4 眼 4 例)和成年期(≥15 岁,23 眼 21 例)发病的视盘小凹伴黄斑病变眼的临床特征、包括钝挫伤史在内的临床病史、眼底检查结果和术中发现。玻璃体粘连的强度通过创建后玻璃体脱离(PVD)所需的操作来分级;1 级=玻璃体切割器,2 级=微钩或镊子,3 级=镊子去除 Cloquet 管残余物。

结果

儿童期发病(4 眼中 3 眼)眼外伤后视力损害的发生率明显高于成年期发病(23 眼中 0 眼,p = 0.0014)。在 4 只儿童期发病眼和 18 只成年期发病眼未自发缓解后,进行了玻璃体手术以形成 PVD。儿童期发病眼的玻璃体粘连程度明显高于成年期发病眼(p = 0.0096)。

结论

眼部外伤可能为发现视盘小凹提供机会。然而,在与视盘边缘有强烈玻璃体粘连的眼中,儿童期发病的视盘小凹伴黄斑病变最常见于钝挫伤后。

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