Kimura Daisaku, Sato Takaki, Oosuka Shou, Kohmoto Ryohsuke, Fukumoto Masanori, Mimura Masashi, Tajiri Kensuke, Kobayashi Takatoshi, Kida Teruyo, Ikeda Tsunehiko
Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan.
Department of Ophthalmology, Takatsuki Red Cross Hospital, Takatsuki-City, Japan.
Case Rep Ophthalmol. 2018 Jan 4;9(1):1-8. doi: 10.1159/000485551. eCollection 2018 Jan-Apr.
Stickler syndrome is an autosomal dominant inherited disorder that is well known to be highly associated with the development of rhegmatogenous retinal detachment. In this study, we report the case of a family affected by Stickler syndrome in which rhegmatogenous retinal detachment developed in 5 eyes of 3 siblings.
For treatment, we performed vitreous surgery on 1 eye of the eldest son, and bilateral scleral buckling surgery on the 2 younger children. A good postoperative outcome was obtained on the 4 eyes that underwent scleral buckling surgery, yet the prognosis was poor on the 1 eye that underwent vitrectomy due to redetachment of the retina and corneal complication. Since vitreous surgery was quite difficult due to strong vitreoretinal adhesion, we created an artificial posterior vitreous detachment via the bimanual technique combined with encircling. For the scleral buckling surgery, broad scleral extrusion was needed to seal multiple retinal breaks.
The findings of this study showed a high prevalence of rhegmatogenous retinal detachment in a single family with Stickler syndrome. In these cases, scleral buckling surgery was effective for treating the detached retina, and some prophylactic treatment, such as laser photocoagulation to prevent the occurrence of rhegmatogenous retinal detachment, should be considered for such cases in the future.
斯-韦二氏综合征是一种常染色体显性遗传性疾病,众所周知与孔源性视网膜脱离的发生高度相关。在本研究中,我们报告了一个受斯-韦二氏综合征影响的家族病例,其中3名兄弟姐妹的5只眼睛发生了孔源性视网膜脱离。
为进行治疗,我们对长子的1只眼睛进行了玻璃体手术,对2名年幼的孩子进行了双侧巩膜扣带术。接受巩膜扣带术的4只眼睛术后效果良好,但接受玻璃体切除术的1只眼睛因视网膜再次脱离和角膜并发症,预后较差。由于玻璃体视网膜粘连严重,玻璃体手术相当困难,我们通过双手操作技术结合环扎术制造了人工玻璃体后脱离。对于巩膜扣带术,需要广泛的巩膜外加压来封闭多个视网膜裂孔。
本研究结果显示,在一个患有斯-韦二氏综合征的家族中,孔源性视网膜脱离的患病率很高。在这些病例中,巩膜扣带术对治疗视网膜脱离有效,未来对此类病例应考虑一些预防性治疗,如激光光凝以预防孔源性视网膜脱离的发生。