Mikhail Mikel, Nofal Nour, Sebag Mikael
*Department of Ophthalmology, McGill University, Montreal, Quebec, Canada; †Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada; and ‡Department of Ophthalmology, Université de Montréal, Montreal, Quebec, Canada.
Retin Cases Brief Rep. 2017;11 Suppl 1:S98-S101. doi: 10.1097/ICB.0000000000000426.
To describe a rare case of an exudative retinal detachment associated with a peripheral tear of the retinal pigment epithelium in a young myopic pachychoroid eye.
Clinical case report and literature review. Imaging was obtained with color fundus photography, spectral domain optical coherence tomography, fluorescein angiography, and fluorescein angiography.
A 33-year-old white man presented with an exudative choroidopathy resulting in an exudative neurosensory detachment, associated with peripheral retinal pigment epithelium tears. Spectral domain optical coherence tomography demonstrated a pachychoroid (628 μm) with subfoveal fluid. Despite a secondary pars-plana vitrectomy with silicone oil and later, Densiron-68 (Labtician Ophthalmics Inc) endotamponade, there was an area of persistent subretinal fluid inferiorly. A previously placed scleral buckle was removed, and scleral window surgery performed, with complete resolution of fluid and restoration of vision. Choroidal thickness improved to 333 μm postoperatively.
Peripheral retinal pigment epithelium tear-associated retinal detachment can be seen in patients with pachychoroid spectrum disease. Scleral window surgery may be considered in the management of these retinal detachments.
描述一例年轻近视性厚脉络膜眼中与视网膜色素上皮周边裂孔相关的渗出性视网膜脱离的罕见病例。
临床病例报告及文献复习。采用彩色眼底照相、光谱域光学相干断层扫描、荧光素血管造影进行成像。
一名33岁白人男性出现渗出性脉络膜病变，导致渗出性神经感觉性脱离，并伴有周边视网膜色素上皮撕裂。光谱域光学相干断层扫描显示脉络膜增厚（628μm），黄斑下有液体积聚。尽管进行了硅油填充的二期玻璃体切除术，随后又进行了Densiron-68（Labtician Ophthalmics Inc）眼内填充，但下方仍有持续性视网膜下液区域。移除先前放置的巩膜扣带，并进行巩膜开窗手术，积液完全消退，视力恢复。术后脉络膜厚度改善至333μm。
厚脉络膜谱系疾病患者可出现与周边视网膜色素上皮撕裂相关的视网膜脱离。在这些视网膜脱离的治疗中可考虑巩膜开窗手术。
