Dell'Arti Laura, Barteselli Giulio, Pinna Valentina, Invernizzi Alessandro, Mapelli Chiara, Viola Francesco
Ophthalmological Unit, Ca' Granda Foundation-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Milan - Italy.
Genentech Inc., South San Francisco, CA - USA.
Eur J Ophthalmol. 2015 Dec 1;26(1):e11-3. doi: 10.5301/ejo.5000679.
To document the occurrence of Roth spots and retinal hemorrhages by spectral-domain optical coherence tomography (SD-OCT) following endoscopic adhesiolysis for failed back surgery syndrome.
Case report.
A 47-year-old patient noted progressive and bilateral visual loss immediately after epidural endoscopy and endoscopic adhesiolysis. Funduscopic examination showed multiple Roth spots and retinal hemorrhages at the posterior pole and the retinal midperiphery in both eyes. Spectral-domain optical coherence tomography demonstrated that Roth spots involved the inner retina, while dot hemorrhages involved the outer retina. Most retinal hemorrhages and Roth spots resolved over 6 weeks, with complete functional recovery in both eyes. However, SD-OCT revealed multiple areas of disruption of the outer retinal layers in the left eye.
Roth spots and retinal hemorrhages can occur after endoscopic spinal surgery. Although hemorrhages resolve quickly over few weeks, SD-OCT can demonstrate that retinal damage might persist, especially in the outer retina. This finding may explain cases of incomplete recovery of visual function after complicated endoscopic adhesiolysis.
记录在因腰椎手术失败综合征行内镜下粘连松解术后，通过谱域光学相干断层扫描（SD-OCT）观察到的 Roth 斑和视网膜出血情况。
病例报告。
一名 47 岁患者在硬膜外内镜检查和内镜下粘连松解术后立即出现进行性双侧视力丧失。眼底检查显示双眼后极部和视网膜中周部有多个 Roth 斑和视网膜出血。谱域光学相干断层扫描显示 Roth 斑累及视网膜内层，而点状出血累及视网膜外层。大多数视网膜出血和 Roth 斑在 6 周内消退，双眼功能完全恢复。然而，SD-OCT 显示左眼视网膜外层有多个区域中断。
内镜下脊柱手术后可出现 Roth 斑和视网膜出血。尽管出血在几周内迅速消退，但 SD-OCT 可显示视网膜损伤可能持续存在，尤其是在外层视网膜。这一发现可能解释了复杂内镜下粘连松解术后视力功能不完全恢复的病例。
