Department of Ophthalmology, Chang Gung Memorial Hospital, No. 6, West section, Chia-Pu RoadPu-Zih City, Chia-Yi County, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
BMC Ophthalmol. 2020 Dec 10;20(1):486. doi: 10.1186/s12886-020-01750-0.
Chorioretinal fold (CFs) is a rare condition resulting from undulations in the choriocapillaris, Bruch's membrane, retinal pigment epithelium and occasionally neurosensory retina. It can be idiopathic or due to different etiologies. The use of spectral-domain optical coherence tomography (SD-OCT) has increased the diagnosis of CFs and helped in differentiation from other etiologies. Recently, optical coherence tomography angiography (OCT-A) emerged as a non-invasive imaging technique allowing visualization of the individual layers of microvasculature of the retina and the choroid by comparing consecutive B-scans. We described a rare case of pleomorphic adenoma of the lacrimal gland (PALG) causing hyperopic shift and CFs with the new OCT-A technology, getting deeper insight into vascular changes of this disease.
A 40-year-old Asian man experienced progressive blurred vision in his right eye over 6 months. The patient's initial axial lengths were 25.55 mm in the right eye and 28.13 mm in the left eye. Fundus examination in the right eye revealed oblique CFs as well as the SD-OCT displayed. Magnetic resonance imaging showed intraconal mass extended from superior temporal side of the right orbit. The patient then received tumor removal surgery through lateral orbitotomy and histopathology confirmed a pleomorphic adenoma of the orbit. The patient had regular follow-up for 1 year. His best corrected visual acuity markedly improved from 20/50 to 20/20 with nearly stationary AXL. We performed OCT-A at one year after the surgery, which showed early visualization of deep choroidal vessels. The scleral remodeling due to mass effect of retrobulbar tumor also caused displacement of the deep large choroidal vessels over the superior macular area even after tumor removal.
We reported a rare case of PALG with hyperopic shift and CFs as initial presentation. Surgical removal of the tumor partially resolved the CFs and contributes to impressive visual acuity recovery. The use of OCT-A provided a deeper insight to vascular architecture changes resulting from scleral remodeling after long-term tumor compression.
脉络膜视网膜皱褶（CFs）是一种罕见的疾病，其特征是脉络膜毛细血管、Bruch 膜、视网膜色素上皮和偶尔的神经感觉视网膜出现波动。它可以是特发性的，也可以是由不同的病因引起的。频域光学相干断层扫描（SD-OCT）的使用增加了 CFs 的诊断，并有助于与其他病因区分开来。最近，光相干断层扫描血管造影（OCT-A）作为一种非侵入性成像技术出现，可以通过比较连续的 B 扫描来观察视网膜和脉络膜的微血管的各个层。我们描述了一例罕见的泪腺多形性腺瘤（PALG）引起远视移位和 CFs 的病例，使用新的 OCT-A 技术深入了解这种疾病的血管变化。
一名 40 岁的亚洲男性右眼渐进性视力模糊超过 6 个月。患者的初始眼轴长度分别为右眼 25.55 毫米和左眼 28.13 毫米。右眼眼底检查发现斜向 CFs，SD-OCT 显示。磁共振成像显示眶内肿块从右眼颞上方延伸。患者随后通过外侧眶切开术接受肿瘤切除术，组织病理学证实为眼眶多形性腺瘤。患者接受了 1 年的定期随访。他的最佳矫正视力从 20/50 显著提高到 20/20，眼轴几乎保持稳定。我们在手术后 1 年进行了 OCT-A，显示了深层脉络膜血管的早期可视化。由于眼后肿瘤的质量效应导致巩膜重塑，即使在肿瘤切除后，深层大脉络膜血管也会在黄斑上方发生移位。
我们报告了一例罕见的以远视移位和 CFs 为首发表现的 PALG 病例。肿瘤切除术部分缓解了 CFs，并有助于显著提高视力恢复。OCT-A 的使用提供了对长期肿瘤压迫后巩膜重塑导致的血管结构变化的更深入了解。
