Ludwig Cassie A, Shields Ryan A, Do Diana V, Moshfeghi Darius M, Mahajan Vinit B
Byers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, CA, USA.
Omics Laboratory, Stanford University, Palo Alto, CA, USA.
Am J Ophthalmol Case Rep. 2019 Feb 16;14:39-46. doi: 10.1016/j.ajoc.2019.02.004. eCollection 2019 Jun.
To describe new cases of sclopetaria and evaluate the risk factors, management, and visual prognosis of all reported cases in the literature.
We performed a retrospective, observational case series. This study included six cases (median age 23, interquartile range 33) of sclopetaria. Additionally, literature searches were conducted in the PubMed and Cochrane Library databases to uncover risk factors associated with all published cases of sclopetaria. Main outcome measure was best corrected visual acuity (BCVA) worse than 20/20. Sixty-seven cases (71 eyes) of sclopetaria have been reported, of which 59 cases (61 eyes) met inclusion criteria in this study. Most were young (median age 19.5 years) men (51/59, 88.1%). Thirty-seven eyes were observed while 24 underwent immediate surgery including six pars plana vitrectomies and three scleral buckles. Compared to initial presentation, BCVA improved in 31/48 (64.6%) eyes, remained stable in 12/48 eyes (25.0%), and worsened in 5/48 eyes (10.4%). Ten patients (16.4%) achieved a final BCVA of 20/20 with median follow up time of seven months. In a multivariate model, location of sclopetaria in the macula, temporal retina, or immediate orbital foreign body removal predicted poor final BCVA with an area under receiver operating characteristic curve of 0.767.
Traumatic chorioretinitis sclopetaria is rare, but reports have increased dramatically over the past two decades. While pars plana vitrectomy may be required for the management of retinal detachments and non-clearing vitreous hemorrhage, close observation is appropriate in most cases. Visual prognosis is poor with most patients attaining 20/200 vision or worse.
描述霰弹样脉络膜视网膜病变的新病例，并评估文献中所有报告病例的危险因素、治疗方法及视力预后。
我们进行了一项回顾性观察病例系列研究。本研究纳入了6例霰弹样脉络膜视网膜病变患者（中位年龄23岁，四分位间距33岁）。此外，还在PubMed和Cochrane图书馆数据库中进行了文献检索，以发现与所有已发表的霰弹样脉络膜视网膜病变病例相关的危险因素。主要观察指标为最佳矫正视力（BCVA）低于20/20。已报告67例（71只眼）霰弹样脉络膜视网膜病变病例，其中59例（61只眼）符合本研究的纳入标准。大多数患者为年轻男性（中位年龄19.5岁，51/59，88.1%）。37只眼接受观察，24只眼立即接受手术，其中包括6例经平坦部玻璃体切除术和3例巩膜扣带术。与初次就诊时相比，48只眼中31只眼（64.6%）的BCVA有所改善, 12只眼（25.0%）保持稳定，5只眼（10.4%）恶化。10例患者（16.4%）最终BCVA达到20/20，中位随访时间为7个月。在多变量模型中，霰弹样脉络膜视网膜病变位于黄斑、颞侧视网膜或立即进行眼眶异物取出术预示最终BCVA较差，受试者工作特征曲线下面积为0.767。
创伤性霰弹样脉络膜视网膜炎很少见，但在过去二十年中报告数量急剧增加。虽然视网膜脱离和不吸收的玻璃体积血可能需要进行平坦部玻璃体切除术，但在大多数情况下密切观察是合适的。大多数患者的视力预后较差，视力达到20/200或更差。
