在曾接受玻璃体切除术的眼中，于门诊进行玻璃体内注射膨胀性气体以治疗黄斑裂孔。
Office-based intravitreal injection of expansile gas for management of macular hole in previously vitrectomized eyes.
作者信息
Apolinario Michael A, Lampen Shaun I R, Wong Tien P, Henry Christopher R, Wykoff Charles C
机构信息
Retina Consultants of Houston, Houston, TX, USA.
Texas A&M Health Science Center College of Medicine, College Station, TX, USA.
出版信息
Am J Ophthalmol Case Rep. 2019 Jul 5;15:100492. doi: 10.1016/j.ajoc.2019.100492. eCollection 2019 Sep.
PURPOSE
To report the successful closure of full-thickness macular hole (MH), using an office-based intravitreal gas injection, in two eyes having undergone prior pars plana vitrectomy (PPV).
OBSERVATIONS
Patient 1 presented with acute loss of visual acuity to 20/300 in the left eye 5 months following PPV for fovea-off rhegmatogenous retinal detachment; MH was confirmed by examination and optical coherence tomography (OCT). 0.6 cc of 100% C3F8 gas was injected, with subsequent MH closure following one week of face-down positioning. Patient 2 presented with right eye visual acuity of 20/60 one month following PPV for optic nerve pit-associated maculopathy; MH was confirmed by examination and OCT. 0.85 cc of 100% C3F8 gas was injected in the office, with subsequent MH closure following one week of face-down positioning.
CONCLUSIONS AND IMPORTANCE
MH management in previously vitrectomized eyes has traditionally been repeat PPV with internal limiting membrane peeling, fluid-air exchange, and expansile gas exchange. Intravitreal gas injection, in an office-based setting, is a viable clinical approach to close MH in some previously vitrectomized eyes.
目的
报告在两只曾接受过玻璃体切割术（PPV）的眼中，通过门诊玻璃体腔注气成功封闭全层黄斑裂孔（MH）。
观察结果
患者1在接受PPV治疗孔源性视网膜脱离（黄斑脱离）5个月后，左眼视力急性下降至20/300；经检查和光学相干断层扫描（OCT）确诊为MH。注入0.6毫升100%的C3F8气体，面朝下体位一周后MH封闭。患者2在接受PPV治疗视神经乳头相关黄斑病变1个月后，右眼视力为20/60；经检查和OCT确诊为MH。在门诊注入0.85毫升100%的C3F8气体，面朝下体位一周后MH封闭。
结论与意义
传统上，对曾接受过玻璃体切割术的眼睛进行MH治疗是再次进行PPV并联合内界膜剥除、液气交换和膨胀性气体交换。在门诊环境下进行玻璃体腔注气，是在一些曾接受过玻璃体切割术的眼中封闭MH的一种可行的临床方法。
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