Kumawat Devesh, Anjum Shahnaz, Sahay Pranita, Chawla Rohan
Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
BMJ Case Rep. 2018 Nov 1;2018:bcr-2018-226952. doi: 10.1136/bcr-2018-226952.
A 29-year-old healthy man had blurring of vision in the left eye for the past 2 months and was referred for the surgical management of optic disc pit maculopathy. Colour fundus examination and optical coherence tomography (OCT) revealed a large deep retinochoroidal excavation close to the temporal edge of the optic disc with an isolated central neurosensory detachment at the macula with underlying multiple small pigment epithelium detachments in the absence of retinoschisis. Fundus fluorescein angiography (FFA) confirmed the presence of multi-focal leakage at the macula and pooling into subretinal space in the form of a 'smoke-stack'. A correct diagnosis of juxtapapillary excavation and central serous chorioretinopathy was made and lifestyle modifications were advised in view of the acute episode. The clinical signs, OCT and FFA feature helped in the differentiation and appropriate management of maculopathy in this case.
一名29岁的健康男性在过去2个月中左眼视力模糊,因视盘凹陷性黄斑病变被转诊接受手术治疗。彩色眼底检查和光学相干断层扫描(OCT)显示,在视盘颞侧边缘附近有一个大的深层视网膜脉络膜凹陷,黄斑区有孤立的中央神经感觉层脱离,其下方有多个小的色素上皮脱离,无视网膜劈裂。眼底荧光血管造影(FFA)证实黄斑区存在多灶性渗漏,并以“烟囱”形式积聚到视网膜下间隙。做出了视乳头旁凹陷和中心性浆液性脉络膜视网膜病变的正确诊断,并鉴于急性发作建议改变生活方式。临床体征、OCT和FFA特征有助于该病例黄斑病变的鉴别和适当处理。