Soibam Ronel, Bhat Parvez Ahmad, Barman Manabjyoti, Bhattacharjee Harsha, Nisa Arsalan Un
Vitreoretinal Services, Sri Sankaradeva Nethralaya, Guwahati, Assam, India.
Department of Ophthalmology, Government Medical College, Srinagar, Jammu and Kashmir, India.
Oman J Ophthalmol. 2018 Sep-Dec;11(3):294-296. doi: 10.4103/ojo.OJO_17_2017.
The purpose of this study was to present the surgical outcome in optic disc pit associated maculopathy in a patient who was treated with vitrectomy, internal limiting membrane (ILM) peeling, barrage laser photocoagulation, and silicone oil tamponade. A 21-year-old Indian male was diagnosed with optic disc pit maculopathy in his left eye with a best-corrected visual acuity (BCVA) of 20/200. A 23-gauge pars plana vitrectomy with peeling of ILM was done using brilliant blue dye. After completion of vitrectomy, fluid-air exchange was performed and silicone oil was instilled into eye. Peripapillary endolaser barrage photocoagulation using two rows of low-intensity laser was performed temporally. Silicone oil was removed 4 months after surgery. During the next 24 months, the retina gradually flattened with gradual improvement of BCVA in the left eye. At 24 months, fundus examination showed retinal pigment epithelium atrophy temporal to optic disc not involving the fovea, and optical coherence tomography showed complete resolution of subretinal fluid, with a BCVA of 20/60. The patient maintained the same vision 4 years following the surgery. vitrectomy combined with posterior hyaloid and ILM peeling followed by silicone oil tamponade, with additional laser photocoagulation, was successful for the treatment of optic disc pit maculopathy in our patient. Further studies are warranted to explore the various treatment options and try to set a standard treatment protocol for this rare challenging condition.
本研究的目的是介绍一名接受玻璃体切除术、内界膜（ILM）剥除术、格栅样激光光凝术和硅油填充术治疗的视盘小凹相关黄斑病变患者的手术结果。一名21岁的印度男性被诊断为左眼视盘小凹黄斑病变，最佳矫正视力（BCVA）为20/200。使用亮蓝染料进行了23G经睫状体平坦部玻璃体切除术及ILM剥除术。玻璃体切除术后，进行了液气交换，并向眼内注入了硅油。颞侧使用两排低强度激光进行视乳头周围视网膜内界膜格栅样光凝。术后4个月取出硅油。在接下来的24个月里，视网膜逐渐变平，左眼BCVA逐渐改善。24个月时，眼底检查显示视盘颞侧视网膜色素上皮萎缩，未累及黄斑中心凹，光学相干断层扫描显示视网膜下液完全消退，BCVA为20/60。术后4年患者视力保持不变。玻璃体切除术联合后玻璃体及ILM剥除术，随后进行硅油填充，并辅以激光光凝，成功治疗了我们这位患者的视盘小凹黄斑病变。有必要进一步开展研究，探索各种治疗方案，并尝试为此罕见的疑难病症制定标准治疗方案。
