Andreev A N, Shvaikin A V, Svetozarskiy S N
Volga District Medical Centre, Federal Medical and Biological Agency, 2 Nizhnevolgskaya Naberejnaya, Nizhny Novgorod, Russian Federation, 603001.
Vestn Oftalmol. 2019;135(6):100-107. doi: 10.17116/oftalma2019135061100.
Peripapillary and macular retinoschisis is one of the rare manifestations of advanced glaucoma of different types. The article presents a case report and a mini-review. Peripapillary and macular retinoschisis with visual deterioration was diagnosed in a patient with advanced decompensated open-angle glaucoma and pseudoexfoliation syndrome. Surgical treatment of glaucoma led to intraocular pressure normalization, gradual regress of retinoschisis and improvement of visual functions. The retinal structure fully restored 1.5 years after the operation. The observation period was 3 years, retinoschisis did not recur. The article discusses the pathogenesis and potential algorithm for the treatment of the disease. Risk factors for the development of retinoschisis include high intraocular pressure, significant visual field defects and a wide range of diurnal intraocular pressure fluctuations. The source of the intra-retinal fluid is the vitreous body. Management of the patient consists of medical, laser and surgical normalization of intraocular pressure and regular monitoring. In case of persisting retinoschisis, patient undergoes vitreoretinal surgery or barrier laser coagulation. Retinal structure recovers gradually after the intervention and takes on average 1 year.
视盘周围和黄斑视网膜劈裂是不同类型晚期青光眼的罕见表现之一。本文呈现了一例病例报告及简要综述。一名患有晚期失代偿性开角型青光眼和假性剥脱综合征的患者被诊断为视盘周围和黄斑视网膜劈裂伴视力下降。青光眼的手术治疗使眼压恢复正常,视网膜劈裂逐渐消退,视功能得到改善。术后1.5年视网膜结构完全恢复。观察期为3年,视网膜劈裂未复发。本文讨论了该疾病的发病机制及潜在治疗方案。视网膜劈裂发生的危险因素包括高眼压、明显的视野缺损和较大范围的眼压日波动。视网膜内液的来源是玻璃体。患者的治疗包括眼压的药物、激光和手术控制以及定期监测。若视网膜劈裂持续存在,患者需接受玻璃体视网膜手术或屏障激光光凝治疗。干预后视网膜结构逐渐恢复,平均需要1年时间。