[伴有中心性视网膜脱离的外伤性黄斑裂孔及锯齿缘离断伴脉络膜破裂]
[Traumatic macular hole with central retinal detachment and choroidal rupture with ora serrata dialysis].
作者信息
Fiorentzis M, Seitz B, Viestenz A
机构信息
Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes UKS, Kirrberger Str. 100, Gebäude 22, 66424, Homburg/Saar, Deutschland,
出版信息
Ophthalmologe. 2015 Aug;112(8):682-5. doi: 10.1007/s00347-014-3216-8.
BACKGROUND
Closed ocular trauma is associated with various retinal complications, such as Berlin's edema, peripheral retinal tears, retinal hemorrhage, choroidal rupture, subretinal bleeding and macular holes. Traumatic macular holes (TMH) are rare and surgical intervention is controversial due to possible spontaneous closure.
CASE REPORT
The positive development in the patient described here indicates that a pars plana vitrectomy with drainage of subretinal hemorrage combined with peeling of the internal limiting membrane (ILM) for a penetrating traumatic macular hole with choroidal rupture can lead to the restoration of visual acuity. The anti-vascular endothelial growth factor (VEGF) therapy (under silicone oil with avastin 0.02 ml) can successfully lead to limitation of posttraumatic choroidal neovascularization (CNV).
CONCLUSIONS
Patients with ocular contusion require extensive long-term ophthalmological follow-up. Furthermore, prevention, education and information is essential to prevent serious injuries.
背景
闭合性眼外伤与多种视网膜并发症相关，如柏林水肿、周边视网膜裂孔、视网膜出血、脉络膜破裂、视网膜下出血和黄斑裂孔。创伤性黄斑裂孔（TMH）较为罕见，由于可能会自发闭合，手术干预存在争议。
病例报告
此处描述的患者的积极进展表明，对于伴有脉络膜破裂的穿透性创伤性黄斑裂孔，行玻璃体视网膜手术联合视网膜下出血引流及内界膜（ILM）剥除术可恢复视力。抗血管内皮生长因子（VEGF）治疗（在硅油下注射0.02 ml阿瓦斯汀）可成功限制创伤后脉络膜新生血管形成（CNV）。
结论
眼挫伤患者需要长期广泛的眼科随访。此外，预防、教育和宣传对于预防严重损伤至关重要。
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