Hwang Young Hoon, Kim Yong Yeon, Kim Hwang Ki, Sohn Yong Ho
Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Myung-Gok Eye Research Institute, #156 Youngdeungpo-dong 4ga, Youngdeungpo-gu, Seoul, 150-034, South Korea,
Graefes Arch Clin Exp Ophthalmol. 2015 Feb;253(2):215-20. doi: 10.1007/s00417-014-2685-4. Epub 2014 Jun 18.
Inner retinal cleavage can be misdiagnosed as a glaucomatous retinal nerve fiber layer (RNFL) defect. This study was performed to characterize eyes with inner retinal cleavage.
Inner retinal cleavage is defined as the appearance of a dark spindle-shaped space between the nerve fibers. Patients who presented at our institution with inner retinal cleavage were enrolled in the study. All participants were evaluated by fundus examination, visual field testing with standard automated perimetry, and optical coherence tomography (OCT) imaging.
A total of 15 eyes of 11 subjects with inner retinal cleavage were included in the study. The median age of the subjects was 57 years (age range, 30-67 years). In each case, inner retinal cleavage was located adjacent to retinal blood vessels. Tissue bridging the cleavage area was observed in ten eyes. Six eyes had epiretinal membranes (ERMs), two eyes had glaucoma, and one eye had ERM in addition to glaucoma. Six eyes with inner retinal cleavage without combined ocular abnormalities had highly myopic refractive error (-6.50 to -8.50 diopters). Cross-sectional OCT images of the areas of inner retinal cleavage demonstrated defects with irregular margins and empty spaces in the inner layers of the retina. During the follow-up period, no eye showed changes in inner retinal layer cleavage or visual field sensitivity.
Inner retinal cleavage was found in eyes with high myopia or ERMs. Inner retinal cleavage was associated with structural changes distinct from those associated with glaucomatous RNFL defects.
视网膜内层劈裂可能被误诊为青光眼性视网膜神经纤维层（RNFL）缺损。本研究旨在对视网膜内层劈裂的眼睛进行特征描述。
视网膜内层劈裂定义为神经纤维之间出现暗纺锤形间隙。在我们机构就诊的视网膜内层劈裂患者纳入本研究。所有参与者均接受眼底检查、标准自动视野计视野检测和光学相干断层扫描（OCT）成像评估。
本研究共纳入11例视网膜内层劈裂患者的15只眼。受试者的中位年龄为57岁（年龄范围30 - 67岁）。在每种情况下，视网膜内层劈裂均位于视网膜血管附近。在10只眼中观察到连接劈裂区域的组织桥。6只眼有视网膜前膜（ERM），2只眼有青光眼，1只眼除青光眼外还有ERM。6只无合并眼部异常的视网膜内层劈裂眼有高度近视屈光不正（-6.50至-8.50屈光度）。视网膜内层劈裂区域的横断面OCT图像显示视网膜内层有边缘不规则的缺损和空隙。在随访期间，没有一只眼的视网膜内层劈裂或视野敏感度出现变化。
在高度近视或有ERM的眼中发现视网膜内层劈裂。视网膜内层劈裂与不同于青光眼性RNFL缺损相关的结构变化有关。
