Ando Yoshimasa, Inoue Makoto, Ohno-Matsui Kyoko, Kusumi Yumi, Iida Tomohiro, Hirakata Akito
*Kyorin Eye Center, Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan; †Department of Ophthalmology, School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan; and ‡Department of Ophthalmology, Tokyo Women's Medical University, Tokyo, Japan.
Retina. 2015 Oct;35(10):1943-50. doi: 10.1097/IAE.0000000000000575.
To report the characteristics of a macular detachment associated with peripapillary intrachoroidal cavitation (ICC) and the outcomes of vitrectomy.
The medical records of 69 eyes of 61 patients who underwent vitrectomy for macular detachment or macular retinoschisis but without vitreomacular traction or optic disc pit were reviewed. Optical coherence tomography was used to determine the morphology of the ICC. The outcomes of vitrectomy including the creation of a posterior vitreous detachment and internal limiting membrane peeling were evaluated.
An ICC was detected in 3 of 3 eyes without pathologic myopia but none in 66 eyes with pathologic myopia (P < 0.0001). Myopic peripapillary conus was present in all 3 eyes, tilted disc in 2 eyes (67%), posterior staphyloma in 1 eye (33%), and no preoperative posterior vitreous detachment in all eyes. Optical coherence tomography detected a connection between the vitreous cavity and the ICC in two eyes with pit-like splitting and between the subretinal space and the ICC in two eyes. The macular detachment was resolved 5 months to 6 months postoperatively with improvement of vision.
A macular detachment with ICC can be present in nonpathological myopic eyes. Vitreous surgery to create a posterior vitreous detachment with internal limiting membrane peeling may help resolve the macular detachment.
报告与视乳头周围脉络膜内空洞（ICC）相关的黄斑脱离的特征及玻璃体切除术的结果。
回顾了61例因黄斑脱离或黄斑视网膜劈裂而接受玻璃体切除术但无玻璃体黄斑牵引或视盘凹陷的患者的69只眼的病历。使用光学相干断层扫描来确定ICC的形态。评估玻璃体切除术的结果，包括形成玻璃体后脱离和内界膜剥除。
3只无病理性近视的眼中有3只检测到ICC，而66只病理性近视的眼中均未检测到（P<0.0001）。所有3只眼中均存在近视性视乳头周围圆锥，2只眼（67%）有斜盘，1只眼（33%）有后巩膜葡萄肿，所有眼术前均无玻璃体后脱离。光学相干断层扫描在2只呈凹状劈裂的眼中检测到玻璃体腔与ICC之间有连接，在2只眼中检测到视网膜下间隙与ICC之间有连接。黄斑脱离在术后5至6个月得到解决，视力有所改善。
非病理性近视眼中可出现伴有ICC的黄斑脱离。通过玻璃体手术形成玻璃体后脱离并剥除内界膜可能有助于解决黄斑脱离。
