Yu Fei, Fu Yao
Department of Ophthalmology, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Eur J Ophthalmol. 2020 Jul 28:1120672120946292. doi: 10.1177/1120672120946292.
We reported the occurrence of a congenital unilateral huge peripapillary staphyloma in association with craniofacial clefts for the first time.
A 1-year-old boy presented with a large defect on his left eyelid, a wide oblique columella nasi and an atypical wedge-shaped extension of the unilateral anterior hairline. Magnetic resonance imaging (MRI) examinations revealed there were cracks on his nasal septum, palate, and superior alveolar midline. Moreover, we surprisingly uncovered a gourd-shaped eyeball with the compressed optic nerve on the right side, while the right eye seemed normal from appearance. Under anaesthesia, fundus examination of the right eye showed a 15 mm-deep excavation surrounding the optic disc with defective choroid and dysplastic optic papilla. We reconstructed the left eyelid of the patient to protect his cornea and would make other solutions according to the results of follow-up.
Peripapillary staphyloma and craniofacial clefts are two dissimilar rare congenital anomalies. In this patient, we firstly observed the co-existence of the two defects, which may provide the experience to the diagnosis and treatment of peripapillary staphyloma and craniofacial clefts. This case also gives us the pathogenic inspiration for further studies of peripapillary staphyloma and craniofacial clefts.
我们首次报告了先天性单侧巨大视乳头周围葡萄肿与颅面裂同时出现的病例。
一名1岁男童,左侧眼睑有一个大缺损,鼻小柱宽阔且呈斜形,单侧前发际线呈非典型楔形延伸。磁共振成像(MRI)检查显示其鼻中隔、腭部和上牙槽中线有裂缝。此外,我们意外地发现右侧眼球呈葫芦形,视神经受压,而右眼外观似乎正常。在麻醉下,对右眼进行眼底检查发现视盘周围有一个15毫米深的凹陷,脉络膜缺损,视乳头发育异常。我们对患者的左侧眼睑进行了重建以保护其角膜,并将根据随访结果制定其他解决方案。
视乳头周围葡萄肿和颅面裂是两种不同的罕见先天性异常。在该患者中,我们首次观察到这两种缺陷同时存在,这可能为视乳头周围葡萄肿和颅面裂的诊断和治疗提供经验。该病例也为视乳头周围葡萄肿和颅面裂的进一步研究提供了发病机制方面的启发。