Baek Jiwon, Lee Jae Hyung, Lee Won Ki
Department of Ophthalmology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Gyeonggi-do, South Korea.
Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Graefes Arch Clin Exp Ophthalmol. 2019 Sep;257(9):1863-1871. doi: 10.1007/s00417-019-04388-x. Epub 2019 Jun 20.
To describe the clinical characteristics and courses for eyes with retinoschisis associated with pachychoroid.
A retrospective interventional case series study. Twenty-one eyes (18 patients) with pachychoroid that showed retinoschisis without evidence of neovascularization that had been followed for 1 year were included. Multimodal imaging, including fundus photography, spectral-domain optical coherence tomography (OCT) with an enhanced depth protocol, fluorescein angiography (FA), and indocyanine green angiography (ICGA), was provided and treatment outcomes were analyzed.
Focal RPE atrophy was present below or adjacent to the schisis in all eyes, and the mean atrophy area was 1.38 ± 1.37 mm. Intraretinal fluids of the schisis originated from the atrophy area and involved the retinal layer which was correlated with the extent of outer retinal defect. Dilated Haller layer vessel and choroidal vascular hyperpermeability were observed under the area with atrophy in all eyes. After 1 year of treatment, 11 eyes (52%) still had fluid and 7 of them had fluid at the macula. Nonetheless, the mean central macular thickness decreased (144.4 to 121.8, P < 0.001), visual acuity improved (0.65 to 0.47, P = 0.026), and subfoveal choroidal thickness decreased (442.2 μm to 394.9 μm, P < 0.001).
Atrophy of RPE can cause retinoschisis in eyes with pachychoroid. The intraretinal fluid that originated from underlying choroid and choroidal thickness decreased as intraretinal fluid diminished.
描述与厚脉络膜相关的视网膜劈裂症患者眼睛的临床特征和病程。
一项回顾性干预性病例系列研究。纳入21只眼睛（18例患者），这些眼睛患有厚脉络膜且出现视网膜劈裂，无新生血管形成迹象，并已随访1年。提供了多模式成像，包括眼底照相、采用增强深度成像协议的光谱域光学相干断层扫描（OCT）、荧光素血管造影（FA）和吲哚菁绿血管造影（ICGA），并分析了治疗结果。
所有眼睛的劈裂下方或附近均存在局灶性视网膜色素上皮（RPE）萎缩，平均萎缩面积为1.38±1.37平方毫米。劈裂的视网膜内液起源于萎缩区域，并累及与视网膜外层缺损范围相关的视网膜层。在所有眼睛萎缩区域下方均观察到Haller层血管扩张和脉络膜血管高渗透性。治疗1年后，11只眼睛（52%）仍有积液，其中7只眼睛黄斑区有积液。尽管如此，平均中心黄斑厚度下降（从144.4降至121.8，P<0.001），视力提高（从0.65提高到0.47，P=0.026），黄斑下脉络膜厚度下降（从442.2μm降至394.9μm，P<0.001）。
RPE萎缩可导致厚脉络膜患者眼睛出现视网膜劈裂。源自脉络膜的视网膜内液随着视网膜内液减少而减少，脉络膜厚度也下降。
