Dar Nimrod, Rubowitz Alexander
Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel.
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Am J Ophthalmol Case Rep. 2018 Mar 7;10:198-200. doi: 10.1016/j.ajoc.2018.03.008. eCollection 2018 Jun.
To report a unique case of pseudo-duplication of the optic disc with maculo-schisis.
A 9-year-old girl presented with decreased vision in the left eye. Her measured visual acuity was 20/50. Dilated fundus examination revealed an optic disc-like lesion with a large crater-like depression, pale color and aberrant retinal vasculature arising from its lower region. Optical coherence tomography (OCT) demonstrated maculo-schisis emerging from the optic disc complex and involving the foveal region. Further pathological findings of cellophane maculopathy with retinal striae was observed at the papillo-macular bundle. On MRI scan there were neither signs of doubling of the optic nerve nor any other optic nerve malformations. The patient underwent 25 Gauge Pars Plana vitrectomy (PPV) with posterior hyaloid peel, ILM peel and gas tamponade with SF6. Eight month post-operatively, a significant reduction in intra-retinal fluids and an improvement in the maculo-schisis magnitude were seen.
To the best of our knowledge, this is the first reported case of a pseudo-duplication of the optic disc with maculo-schisis treated with PPV.
报告一例伴有黄斑劈裂的视盘假性重复的独特病例。
一名9岁女孩因左眼视力下降就诊。其测得的视力为20/50。散瞳眼底检查发现一个视盘样病变,有一个大的火山口样凹陷,颜色苍白,视网膜血管异常从其下部区域发出。光学相干断层扫描(OCT)显示黄斑劈裂从视盘复合体出现并累及黄斑区。在视乳头黄斑束处观察到有视网膜条纹的玻璃纸样黄斑病变的进一步病理表现。MRI扫描既未发现视神经双份的迹象,也未发现任何其他视神经畸形。该患者接受了25G玻璃体切割术(PPV),包括后玻璃体后皮质剥除、内界膜剥除及用SF6气体填充。术后8个月,视网膜内液明显减少,黄斑劈裂程度有所改善。
据我们所知,这是首例报道的采用PPV治疗伴有黄斑劈裂的视盘假性重复病例。