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高度近视眼中与血管旁异常相关的裂孔导致的视网膜脱离。

Retinal detachment due to paravascular abnormalities-associated breaks in highly myopic eyes.

机构信息

Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.

College of Medicine, National Taiwan University, Taipei, Taiwan.

出版信息

Eye (Lond). 2019 Apr;33(4):572-579. doi: 10.1038/s41433-018-0255-4. Epub 2018 Nov 1.

Abstract

PURPOSE

To describe the characteristics of a novel type of retinal detachment (RD) due to paravascular abnormalities (PVAs) associated breaks in highly myopic eyes.

METHODS

We retrospective recruited eight eyes with RD due to PVA-associated breaks. The clinical features and surgical results were evaluated.

RESULTS

All eyes were highly myopic with a mean axial length of 31.31 ± 2.86 mm (27.51-36.52 mm). Two of the eight eyes had multiple paravascular retinal breaks associated with PVAs, four had a single paravascular break with PVAs nearby, and two had multiple paravascular breaks along the same vessels. All breaks were round or oval-shaped, and only three eyes (37.5%) had their breaks located over patchy chorioretinal atrophy. Two of the eight eyes had the breaks outside the arcades, five had their breaks within the arcades, and one had a break within the arcade as well as breaks outside the arcade. Vitrectomy and epiretinal and internal limiting membrane peeling were performed in all cases, with inverted or free internal limiting membrane flap insertions for the perifoveal breaks and endolaser for the more peripheral breaks. All eyes had retinal reattachment after one single operation.

CONCLUSION

RD due to PVA-associated breaks represented a distinct entity. PVAs and the associated breaks should be searched in RD without macular hole or obvious breaks in highly myopic eyes. It may be treated as RD caused by peripheral breaks or as macular hole associated RD depending on the location of the breaks.

摘要

目的

描述一种与血管周围异常(PVA)相关的裂孔性视网膜脱离(RD)的新型病变特征,该病变与高度近视眼有关。

方法

我们回顾性招募了 8 例因 PVA 相关裂孔导致 RD 的患者。评估了他们的临床特征和手术结果。

结果

所有眼均为高度近视,平均眼轴长度为 31.31±2.86mm(27.51-36.52mm)。8 只眼中有 2 只眼有多个与 PVA 相关的视网膜裂孔,4 只眼有 1 个 PVA 附近的单一裂孔,2 只眼有多个沿同一血管的裂孔。所有裂孔均呈圆形或椭圆形,只有 3 只眼(37.5%)的裂孔位于斑状脉络膜萎缩区。8 只眼中有 2 只眼的裂孔位于锯齿状缘外,5 只眼的裂孔位于锯齿状缘内,1 只眼的裂孔位于锯齿状缘内和锯齿状缘外。所有病例均行玻璃体切割术和视网膜内界膜及内界膜剥除术,对周边部裂孔采用翻转或游离内界膜瓣填塞,对更周边部裂孔采用眼内激光光凝。所有眼单次手术后视网膜均复位。

结论

与 PVA 相关的裂孔性 RD 是一种独特的病变。在无黄斑裂孔或明显裂孔的高度近视性 RD 患者中,应寻找 PVA 及其相关裂孔。根据裂孔的位置,该病变可能被视为周边部裂孔性 RD 或黄斑裂孔相关性 RD。

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