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自体神经感觉视网膜瓣用于治疗黄斑毛细血管扩张症患者难治性黄斑裂孔的封闭。

Autologous neurosensory retinal flap for closure of refractory macular hole in a patient with macular telangiectasia.

作者信息

Hewson Andrew, McAllister Andrew, Reddie Ian

机构信息

Townsville Hospital, 100 Angus Smith Dr, Douglas, QLD, 4814, Australia.

出版信息

Am J Ophthalmol Case Rep. 2020 Mar 7;18:100644. doi: 10.1016/j.ajoc.2020.100644. eCollection 2020 Jun.

DOI:10.1016/j.ajoc.2020.100644
PMID:32215339
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7083780/
Abstract

PURPOSE

This study explores autologous neurosensory autograph for a patient with a chronic full-thickness macular hole (FTMH) and idiopathic macular telangiectasia type 2 (IMT2).

OBSERVATIONS

The patient had a chronic 1355 μm FTMH and best corrected visual acuity (BCVA) of 2 logMAR units after two unsuccessful attempts to close the macular hole. Following a 25-gauge vitrectomy, a 2-disc diameter neurosensory autograft from the supertemporal retina was mobilized and secured with perfluoro-N-octane (PFO) tamponade. After being postured supine for one week, the PFO was exchanged for silicone oil. Two months later, silicone oil was exchanged for 20% sulphur hexafluoride (SF6).

CONCLUSIONS AND IMPORTANCE

The graft achieved anatomical and functional success with BCVA of 0.6 logMAR units. This case supports autologous neurosensory autograph as a technique for achieving closure of chronic macular holes refractory to conventional treatment.

摘要

目的

本研究探讨自体神经感觉移植术用于一名患有慢性全层黄斑裂孔（FTMH）和特发性2型黄斑毛细血管扩张症（IMT2）的患者。

观察结果

该患者有一个慢性的1355μm全层黄斑裂孔，在两次黄斑裂孔封闭尝试失败后，最佳矫正视力（BCVA）为2 logMAR单位。在进行25G玻璃体切除术后，从颞上视网膜获取一个2视盘直径的神经感觉自体移植物，并用全氟正辛烷（PFO）填塞固定。仰卧位姿势保持一周后，将PFO换成硅油。两个月后，将硅油换成20%的六氟化硫（SF6）。

结论与意义

移植物实现了解剖学和功能上的成功，最佳矫正视力为0.6 logMAR单位。该病例支持自体神经感觉移植术作为一种用于封闭传统治疗难治的慢性黄斑裂孔的技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5469/7083780/b548d42dd33f/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5469/7083780/98d57beb35d9/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5469/7083780/77fd0ed9d05a/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5469/7083780/ec291a9cd311/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5469/7083780/adb87a03a0fa/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5469/7083780/48e7da064a1d/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5469/7083780/b548d42dd33f/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5469/7083780/98d57beb35d9/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5469/7083780/77fd0ed9d05a/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5469/7083780/ec291a9cd311/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5469/7083780/adb87a03a0fa/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5469/7083780/48e7da064a1d/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5469/7083780/b548d42dd33f/fx1.jpg

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本文引用的文献

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JAMA Ophthalmol. 2016 Feb;134(2):229-30. doi: 10.1001/jamaophthalmol.2015.5237.
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Outcomes of macular hole surgeries for macular telangiectasia type 2.2型黄斑毛细血管扩张症黄斑裂孔手术的治疗结果
Retina. 2014 May;34(5):907-15. doi: 10.1097/IAE.0000000000000009.
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Evolution and management of macular hole secondary to type 2 idiopathic macular telangiectasia.继发于2型特发性黄斑毛细血管扩张症的黄斑裂孔的演变与处理
Eye (Lond). 2011 Apr;25(4):532-3. doi: 10.1038/eye.2010.233. Epub 2011 Jan 21.
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Vitreous surgery for chronic macular holes.慢性黄斑裂孔的玻璃体手术
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