Chen Ta-Ching, Yang Chang-Hao, Sun Jen-Pin, Chen Muh-Shy, Yang Chung-May
Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung Shan South Road, Taipei, Taiwan.
Graefes Arch Clin Exp Ophthalmol. 2015 Sep;253(9):1437-46. doi: 10.1007/s00417-014-2829-6. Epub 2014 Nov 4.
To investigate the clinical characteristics and treatment outcomes of macular retinal detachment (MRD) associated with intrachoroidal cavitation (ICC) in myopic patients.
In this retrospective, consecutive, interventional case series, five patients with ICC and associated MRD were enrolled from January 2005 to December 2012. Basic ocular characteristics and clinical appearances of their ICC and MRD were recorded. Individual treatment courses were assessed with fundus photographs and serial optical coherence tomography.
The average age and refraction were 43.8 ± 11.0 years old and -9.37 ± 2.73 diopters, respectively. Initial BCVA ranged from 20/100 to 20/30. Definite communication between the ICC and the subretinal space was noted in one case, suspected curvilinear communication in two cases, and between the peripapillary area and the subretinal space in two cases. Two cases received intravitreal injection of perfluoropropane and peripapillary laser; subretinal fluid (SRF) resolved in one and decreased in the other. One case had SRF reabsorbed after prolonged use of topical carbonic anhydrase inhibitor.
ICC in high myopic patients may be associated with MRD. There might be communication between the ICC and the subretinal space. Intravitreal injection of an expansile gas may be beneficial, but the best treatment remains undetermined.
探讨近视患者脉络膜内空洞(ICC)相关黄斑视网膜脱离(MRD)的临床特征及治疗效果。
在这个回顾性、连续性、介入性病例系列研究中,2005年1月至2012年12月纳入了5例患有ICC及相关MRD的患者。记录其基本眼部特征以及ICC和MRD的临床表现。通过眼底照片和系列光学相干断层扫描评估个体治疗过程。
平均年龄和屈光度分别为43.8±11.0岁和-9.37±2.73屈光度。初始最佳矫正视力(BCVA)范围为20/100至20/30。1例观察到ICC与视网膜下间隙有明确的连通,2例怀疑有曲线连通,2例在视乳头周围区域与视网膜下间隙之间存在连通。2例接受了玻璃体腔内注射全氟丙烷和视乳头周围激光治疗;1例视网膜下液(SRF)消退,另1例减少。1例在长期使用局部碳酸酐酶抑制剂后SRF吸收。
高度近视患者的ICC可能与MRD相关。ICC与视网膜下间隙之间可能存在连通。玻璃体腔内注射膨胀性气体可能有益,但最佳治疗方法仍未确定。