Rashaed Saba Al
Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Clin Ophthalmol. 2013;7:1069-72. doi: 10.2147/OPTH.S40208. Epub 2013 Jun 5.
The purpose of this paper is to report an unusual case of accumulation of residual subretinal fluid after surgery for acute rhegmatogenous retinal detachment, sparing the fovea. A 28-year-old male presented with a four-day history of acute visual loss in his right eye secondary to bulbous rhegmatogenous retinal detachment, sparing the fovea. The patient underwent an uneventful pars plana vitrectomy and scleral buckling procedure. At four weeks postoperatively (after complete gas resorption), the visual acuity was 20/40. However, the patient complained of blurred vision. A dilated fundus examination showed a fat retina and the presence of multiple yellowish subretinal deposits resembling vitelliform lesions in the macula. Some lesions were encroaching on the fovea, and were connected via a tract to a previous horseshoe tear with evidence of a thin layer of subretinal fluid. The patient symptoms persisted for one year postoperatively. However, the retina remained fat with evidence of retinal pigment epithelium mottling and faint scars corresponding to previous lesions. Persistent subretinal fluid with thick subretinal precipitate can occur even after successful surgery for acute retinal detachment sparing the fovea and cause visual dysfunction.
本文旨在报告一例急性孔源性视网膜脱离手术后残留视网膜下液积聚的罕见病例，黄斑未受影响。一名28岁男性，因球性孔源性视网膜脱离导致右眼急性视力丧失4天，黄斑未受影响。患者接受了顺利的玻璃体切除术和平坦部巩膜扣带术。术后四周（气体完全吸收后），视力为20/40。然而，患者抱怨视力模糊。散瞳眼底检查显示视网膜增厚，黄斑区存在多个类似卵黄样病变的黄色视网膜下沉积物。一些病变侵犯了黄斑，并通过一条条索与先前的马蹄形裂孔相连，有视网膜下液薄层的证据。患者症状术后持续了一年。然而，视网膜仍然增厚，有视网膜色素上皮斑驳和与先前病变相对应的淡瘢痕的证据。即使在成功进行了保留黄斑的急性视网膜脱离手术后，仍可能出现伴有厚视网膜下沉淀物的持续性视网膜下液，并导致视觉功能障碍。
