Sheng Jiwei, Levinson Joshua D, Reilly Gayatri, Patronas Marena, Lai Michael M
Ophthalmic Surg Lasers Imaging Retina. 2017 Jun 1;48(6):488-492. doi: 10.3928/23258160-20170601-07.
Postoperative retinal folds are a rare complication of retinal detachment repair. Folds involving the macula may result in decreased vision, metamorphopsia, and diplopia. There is no consensus on whether symptomatic folds require additional surgery, as both spontaneous regression and permanent vision loss have been described. The authors present three cases of symptomatic macular folds that demonstrated spontaneous resolution and identify key OCT prognostic signs.
The study presented is a retrospective case series.
Three patients developed symptomatic postoperative macular folds. Despite funduscopic appearances indistinguishable from full-thickness folds, optical coherence tomography (OCT) imaging revealed that none of the folds involved the full thickness of the retina. All cases demonstrated spontaneous resolution with evidence of visual improvement within 2 months.
OCT is essential in distinguishing between partial and full-thickness macular folds. The authors propose that partial-thickness folds should be termed "pseudo-folds," which represent a unique entity that has a favorable natural history. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:488-492.].
术后视网膜皱褶是视网膜脱离修复术后一种罕见的并发症。累及黄斑的皱褶可能导致视力下降、视物变形和复视。对于有症状的皱褶是否需要额外手术尚无共识,因为既有自发消退的情况,也有永久性视力丧失的报道。作者介绍了3例有症状的黄斑皱褶病例,这些病例显示出自发消退,并确定了光学相干断层扫描(OCT)的关键预后征象。
本研究为回顾性病例系列研究。
3例患者出现有症状的术后黄斑皱褶。尽管眼底表现与全层皱褶难以区分,但光学相干断层扫描(OCT)成像显示,这些皱褶均未累及视网膜全层。所有病例均自发消退,且在2个月内有视力改善的证据。
OCT对于区分部分厚度和全层黄斑皱褶至关重要。作者提出,部分厚度的皱褶应称为“假性皱褶”,这代表了一种具有良好自然病程的独特实体。[《眼科手术、激光与视网膜成像》。2017;48:488 - 492。]