Han Liang, Cho Yen-Ling, Ma Zhizhong, Zhao Xinrong, Chang Xin
Department of Ophthalmology, Peking University Third Hospital, Beijing, China.
Department of Ophthalmology, Peking University International Hospital, Beijing, China.
Taiwan J Ophthalmol. 2018 Jan-Mar;8(1):36-41. doi: 10.4103/tjo.tjo_61_17.
The purpose of this study is to observe the characteristics of intrachoroidal splitting (ICS) associated with choroidal detachment due to open-globe injury.
A retrospective, observational case series study of four eyes diagnosed with choroidal detachment exhibited ICS. The pathologic changes of the ICS were recorded during surgery. Four specimens were obtained from the inner part of the ICS region. One specimen was stained with hematoxylin and eosin; one specimen was examined under scanning electron microscopy, and the other two specimens were examined under transmission electron microscopy.
All four patients presented with vortex vein rupture associated with large-scaled mid-peripheral ICS. The histopathologic observations indicated that ICS occurred between the medium-sized and large-sized choroidal vessel layers. Large vascular indentations and medium-sized choroidal vessels were observed on the inner part of the split interface. Postoperative outcomes of the four patients were poor. Vision in all four patients was no light perception before or after surgery. Three eyes became atrophic with silicon oil tamponade and band keratopathy, one eye was eventually enucleated for cosmetic reason.
Intrachoroidal tissue has the potential to split during trauma. The outcome of ICS with choroidal detachment in open-globe injury was poor.
本研究旨在观察开放性眼球损伤所致脉络膜脱离相关的脉络膜层间分离（ICS）的特征。
对4例诊断为脉络膜脱离且伴有ICS的患者进行回顾性观察病例系列研究。手术中记录ICS的病理变化。从ICS区域内部获取4个标本。1个标本进行苏木精-伊红染色；1个标本进行扫描电子显微镜检查，另外2个标本进行透射电子显微镜检查。
所有4例患者均出现与大范围中周部ICS相关的涡静脉破裂。组织病理学观察表明，ICS发生在中、大型脉络膜血管层之间。在分离界面内部观察到大型血管压迹和中型脉络膜血管。4例患者的术后预后较差。所有4例患者术前术后均无光感。3只眼因硅油填充和带状角膜病变而萎缩，1只眼最终因美容原因被摘除眼球。
脉络膜组织在创伤时具有层间分离的可能性。开放性眼球损伤中伴有脉络膜脱离的ICS预后较差。
