中心凹裂：孔源性视网膜脱离玻璃体切除术后黄斑裂孔的 OCT 征象。
Foveal Crack Sign: An OCT Sign Preceding Macular Hole After Vitrectomy for Rhegmatogenous Retinal Detachment.
机构信息
Department of Ophthalmology, Osaka Rosai Hospital Clinical Research Center for Optical Sensory Organ Disability, Osaka, Japan.
Department of Ophthalmology, Osaka Rosai Hospital Clinical Research Center for Optical Sensory Organ Disability, Osaka, Japan; Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
出版信息
Am J Ophthalmol. 2020 Oct;218:192-198. doi: 10.1016/j.ajo.2020.05.030. Epub 2020 May 29.
PURPOSE
To describe an optical coherence tomography (OCT) sign preceding macular hole (MH) formation after pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).
DESIGN
Retrospective observational case series.
METHODS
Patients who underwent PPV for RRD at Osaka Rosai Hospital between January 2014 and December 2017 were examined. First, the medical records of the patients who had secondary MH after RRD repair were examined, and their sequential changes of the OCT images until MH formation were evaluated. Second, the OCT findings and the medical records of all patients who underwent PPV for RRD were evaluated based on the findings of the cases of secondary MH.
RESULTS
Ten eyes of 10 patients who had secondary MH after PPV for RRD were enrolled. Before MH formation, all eyes had parafoveal epiretinal membrane (ERM) and a characteristic OCT sign that was termed a foveal crack sign (FCS), a hyperreflective vertical line in the foveola with a deformation of the fovea. FCS was found 255 ± 217 days after PPV for RRD, and MH developed 232 ± 171 days after FCS appearance. Furthermore, among 518 eyes that underwent PPV for RRD, FCS with parafoveal ERM was found in 3 eyes without succeeding MH after RRD repair. FCS of these 3 eyes were found 363 ± 4 days after PPV for RRD.
CONCLUSIONS
In all cases of secondary MH formation after PPV for RRD, FCS with parafoveal ERM was found before MH formation. This sign may predict secondary MH formation caused by ERM traction.
目的
描述孔源性视网膜脱离（RRD）行玻璃体切除术后黄斑裂孔（MH）形成前的光学相干断层扫描（OCT）征象。
设计
回顾性观察性病例系列。
方法
检查 2014 年 1 月至 2017 年 12 月期间在大阪 Rosai 医院接受 RRD 修复的患者。首先，检查 RRD 修复后发生继发性 MH 的患者的病历，并评估其 OCT 图像的连续变化直至 MH 形成。其次，根据继发性 MH 病例的发现，评估所有接受 RRD 行玻璃体切除术的患者的 OCT 发现和病历。
结果
共纳入 10 例 10 眼 RRD 行玻璃体切除术后发生继发性 MH 的患者。在 MH 形成之前，所有眼均有黄斑旁视网膜前膜（ERM）和特征性 OCT 征象，称为黄斑裂孔裂孔征（FCS），即黄斑中心凹处出现一条垂直高反射线，伴有黄斑变形。FCS 在 RRD 行玻璃体切除术后 255±217 天发现，MH 在 FCS 出现后 232±171 天发生。此外，在 518 例接受 RRD 行玻璃体切除术后，有 3 例无 RRD 修复后继发性 MH 的眼发现伴有黄斑旁 ERM 的 FCS。这 3 例眼的 FCS 在 RRD 行玻璃体切除术后 363±4 天发现。
结论
在所有 RRD 行玻璃体切除术后发生继发性 MH 的病例中，在 MH 形成之前发现伴有黄斑旁 ERM 的 FCS。该征象可能预测由 ERM 牵引引起的继发性 MH 形成。
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