Fukumoto Masanori, Oosuka Shou, Sato Takaki, Kida Teruyo, Ikeda Tsunehiko
Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan.
Case Rep Ophthalmol. 2020 Jan 7;11(1):16-21. doi: 10.1159/000505315. eCollection 2020 Jan-Apr.
In this paper, we report an extremely rare case of spontaneous closure of a macular hole (MH) that developed in a patient in whom acquired vitelliform lesion (AVL) occurred after vitrectomy for atopic retinal detachment (ARD). A 32-year-old male developed ARD in both eyes, and retinal reattachment was achieved after vitrectomy. Five years after surgery, optical coherence tomography showed localized serous retinal detachment (SRD) and a granular lesion with a higher brightness in the subretinal fluid, thus leading to the diagnosis of AVL. One month later, an MH developed, and a follow-up examination performed 6 weeks later revealed that the MH had spontaneously closed and the SRD decreased. In the fovea, fluorescein angiography revealed a window defect due to atrophy of the retinal pigment epithelium (RPE). These findings in this present case suggest the possibility that RPE dysfunction was involved in the development of AVL and MH.
在本文中，我们报告了一例极为罕见的黄斑裂孔（MH）自发闭合的病例，该病例发生在一名因特应性视网膜脱离（ARD）接受玻璃体切除术后出现获得性卵黄样病变（AVL）的患者身上。一名32岁男性双眼发生ARD，玻璃体切除术后视网膜实现复位。术后5年，光学相干断层扫描显示局限性浆液性视网膜脱离（SRD）以及视网膜下液中亮度较高的颗粒状病变，从而诊断为AVL。1个月后出现MH，6周后进行的随访检查显示MH已自发闭合且SRD减轻。在黄斑中心凹，荧光素血管造影显示由于视网膜色素上皮（RPE）萎缩导致的窗样缺损。本病例中的这些发现提示RPE功能障碍可能参与了AVL和MH的发生。
