*Rothschild Ophthalmologic Foundation, Paris, France; and †Centre Ophtalmologique Rabelais, Lyon, France.
Retina. 2013 Nov-Dec;33(10):2133-8. doi: 10.1097/IAE.0b013e31828e68d0.
Optic atrophy constitutes the final stage in the evolution of optic neuropathy. The aim of this study was to describe the presence of macular microcystic changes or pseudocysts in patients with advanced optic atrophy.
The medical records of 24 patients who had retinal pseudocysts in association with optic atrophy have been analyzed. All patients underwent a complete neuro-ophthalmologic assessment; peripapillary retinal nerve fiber layer thickness and macular screening with spectral-domain optical coherence tomography and optical coherence tomography "en face" imaging analysis were also performed.
A total of 36 eyes were included in the study. Patients' mean age was 37 years. The major cause of optic atrophy was glaucoma (12 cases). The retinal pseudocysts were observed as hyporeflective lesions in the internal nuclear layer. Infrared images revealed a hyporeflective circular or semilunar shape corresponding to the location of the pseudocysts in all cases. In eyes with pseudocysts, mean thickness of the peripapillary retinal nerve fiber layer was statistically significantly less than that of fellow eyes (P = 0.0003), whereas macular thickness was statistically significantly higher compared with fellow eyes (P < 0.005).
The presence of pseudocystic lesions always associated with severe optic nerve fiber loss is reported. The reason why pseudocystic lesions develop within the retina is not well understood. They might constitute the translation of degeneration of Muller cells in severe optic nerve fiber loss. Recognizing these pseudocysts is crucial because they may be confused with cystoid macular edema. Their prognostic value and role in the therapeutic process need to be further evaluated with prospective studies and molecular experiments in vivo.
视盘萎缩是视神经病变发展的终末阶段。本研究旨在描述晚期视神经萎缩患者中黄斑微囊样改变或假性囊肿的存在情况。
分析了 24 例伴有视神经萎缩的视网膜假性囊肿患者的病历。所有患者均接受了完整的神经眼科评估；还进行了视盘周围视网膜神经纤维层厚度和黄斑筛查，包括频域光相干断层扫描和光相干断层扫描“面”成像分析。
共有 36 只眼纳入研究。患者的平均年龄为 37 岁。视神经萎缩的主要原因是青光眼（12 例）。视网膜假性囊肿在核内层呈低反射性病变。所有病例的红外图像均显示低反射性圆形或半月形，与假性囊肿的位置相对应。在存在假性囊肿的眼中，视盘周围视网膜神经纤维层的平均厚度明显小于对侧眼（P = 0.0003），而黄斑厚度明显高于对侧眼（P < 0.005）。
报道了始终与严重视神经纤维损失相关的假性囊肿病变的存在。假性囊肿病变在视网膜内发展的原因尚不清楚。它们可能代表严重视神经纤维损失中 Muller 细胞变性的转化。识别这些假性囊肿至关重要，因为它们可能与囊样黄斑水肿相混淆。它们的预后价值和在治疗过程中的作用需要通过前瞻性研究和体内分子实验进一步评估。
