Lorusso Massimo, Zito Roberta, Micelli Ferrari Luisa, Nikolopoulou Eleni, Cicinelli Maria Vittoria, Borrelli Enrico, Querques Giuseppe, Micelli Ferrari Tommaso
Department of Ophthalmology, Ente Ecclesiastico Ospedale Generale Regionale 'F, Miulli', Bari, Italy.
Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.
Ther Adv Ophthalmol. 2020 Aug 26;12:2515841420950843. doi: 10.1177/2515841420950843. eCollection 2020 Jan-Dec.
The separation of the vitreous from the optic nerve head and the macula plays a primary role in the spontaneous resolution of optic disc pit (ODP) maculopathy. Optical coherence tomography (OCT) helps in the non-invasive monitoring of this condition, when treated conservatively. The aim of this report was to describe a pediatric case of spontaneously resolved ODP maculopathy, managed conservatively and monitored by means of spectral domain (SD)-OCT. A 14-year-old girl presented with severe visual loss in the right eye (RE). Fundus examination demonstrated a temporal ODP with altered foveal reflex. The SD-OCT B-scans revealed severe intraretinal schisis-like changes, broad vitreal adhesion in the optic nerve head area, posterior hyaloid thickening, and vitreal entrapment in the premacular space. The patient was managed conservatively. Spontaneous resolution of ODP maculopathy took place over 3 months, with vision improved up to 1.0 (Snellen charts). The macular schisis progressively resolved after posterior vitreous detachment. In conclusion, in our report, a complete restoration of the foveal anatomy was achieved without any surgical intervention. This OCT-based report confirms the role of the vitreomacular abnormalities in the pathogenesis of the disease.
玻璃体与视神经乳头及黄斑的分离在视盘小凹(ODP)黄斑病变的自然消退中起主要作用。在保守治疗时,光学相干断层扫描(OCT)有助于对这种情况进行无创监测。本报告的目的是描述一例经保守治疗并通过光谱域(SD)-OCT监测的小儿ODP黄斑病变自然消退病例。一名14岁女孩右眼出现严重视力丧失。眼底检查发现颞侧视盘小凹,中心凹反射改变。SD-OCT B扫描显示视网膜内严重的劈裂样改变、视神经乳头区域广泛的玻璃体粘连、后玻璃体增厚以及黄斑前间隙的玻璃体嵌顿。该患者接受了保守治疗。ODP黄斑病变在3个月内自然消退,视力提高至1.0(斯内伦视力表)。玻璃体后脱离后黄斑劈裂逐渐消退。总之,在我们的报告中,未经任何手术干预就实现了中心凹解剖结构的完全恢复。这份基于OCT的报告证实了玻璃体黄斑异常在该疾病发病机制中的作用。