Savoie Brian T, Ferrone Philip J
*Department of Ophthalmology, Hofstra Northwell School of Medicine, Great Neck, New York; and †Long Island Vitreoretinal Consultants, Great Neck, New York.
Retin Cases Brief Rep. 2017;11 Suppl 1:S202-S210. doi: 10.1097/ICB.0000000000000444.
To describe the treatment and natural history of a patient with complicated congenital retinoschisis.
A retrospective case report. A 10-month-old boy with congenital retinoschisis presented with tractional retinal detachments and foveal schisis in both eyes.
On presentation, vision was decreased in both eyes with presumed amblyopia of the left eye. Funduscopic examination revealed bilateral foveal schisis and tractional retinal detachment involving the macula. Follow-up examination revealed superior retinal dragging and peripheral ischemia on fluorescein angiogram in both eyes. Nine months after presentation, combined rhegmatogenous and tractional retinal detachment developed in the right eye and was treated by scleral buckle. After vitrectomy for nonclearing vitreous hemorrhage in the left eye, a combined rhegmatogenous and tractional retinal detachment developed. Vitrectomy and lensectomy with silicone oil was performed. At 6 years of follow-up, both retinas were attached and foveal schisis had resolved.
Sight threatening complications of congenital retinoschisis include retinal detachment and vitreous hemorrhage. Vitrectomy and/or scleral buckling may prevent progression of vision loss and promote resolution of schisis.
描述一名患有复杂性先天性视网膜劈裂症患者的治疗情况及自然病程。
一项回顾性病例报告。一名患有先天性视网膜劈裂症的10个月大男孩双眼出现牵拉性视网膜脱离和黄斑劈裂。
初诊时，双眼视力下降，左眼推测为弱视。眼底检查发现双眼黄斑劈裂及累及黄斑的牵拉性视网膜脱离。随访检查显示双眼荧光素血管造影可见视网膜上方牵拉和周边缺血。初诊9个月后，右眼发生孔源性和牵拉性视网膜脱离合并症，并接受巩膜扣带术治疗。左眼因玻璃体出血不吸收行玻璃体切除术后，发生孔源性和牵拉性视网膜脱离合并症。遂行玻璃体切除术及晶状体切除术并注入硅油。随访6年时，双眼视网膜均已复位，黄斑劈裂已消退。
先天性视网膜劈裂症的视力威胁性并发症包括视网膜脱离和玻璃体出血。玻璃体切除术和/或巩膜扣带术可能会阻止视力丧失的进展并促进劈裂的消退。
