Todorich Bozho, Sharma Sumit, Vajzovic Lejla
*Associated Retinal Consultants and William Beaumont Hospital, Royal Oak, Michigan; and †Duke University Eye Center, Durham, North Carolina.
Retin Cases Brief Rep. 2017;11(1):15-17. doi: 10.1097/ICB.0000000000000276.
To describe vitreoretinal surgical technique of using autologous platelet-rich plasma to aid in surgical repair of optic pit maculopathy refractive to previous vitrectomy.
A case of an 18-year-old woman presenting with serous macular detachment secondary to optic pit is reported. Patient had previously undergone vitrectomy and peripapillary laser, but had recurrence of subretinal fluid and worsening visual acuity. Autologous platelet-rich plasma was harvested from the patient's blood and purified using Arthrex ACP kit (Arthrex, Inc, Naples, FL). Repeat pars plana vitrectomy was performed with internal limiting membrane peeling extending to the optic nerve. Platelet-rich plasma was layered over the pit and long-acting gas tamponade performed with face-down positioning.
At 8 months of follow-up, subretinal fluid was resolved, the connection between optic pit and subretinal space collapsed and the ellipsoid zone near completely reconstituted on optical coherence tomography. The patient's vision improved significantly from 20/100 to 20/50, which is largely limited by posterior subcapsular cataract.
Platelet-rich plasma can augment anatomical and visual outcomes in surgical repair of optic pit maculopathy.
描述使用自体富血小板血浆辅助手术修复对先前玻璃体切除术无效的视盘小凹黄斑病变的玻璃体视网膜手术技术。
报告1例18岁女性因视盘小凹继发浆液性黄斑脱离的病例。患者先前已接受玻璃体切除术和视乳头周围激光治疗,但仍有视网膜下液复发且视力恶化。从患者血液中采集自体富血小板血浆,并使用Arthrex ACP试剂盒(Arthrex公司,那不勒斯,佛罗里达州)进行纯化。再次行玻璃体切除术,内界膜剥除延伸至视神经。将富血小板血浆覆盖在视盘小凹上,并采用面朝下体位进行长效气体填塞。
随访8个月时,视网膜下液消退,视盘小凹与视网膜下间隙的连接消失,光学相干断层扫描显示椭圆体带几乎完全重建。患者视力从20/100显著提高到20/50,主要受后囊下白内障限制。
富血小板血浆可改善视盘小凹黄斑病变手术修复的解剖和视觉效果。