Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Rd, Hangzhou, 310009, China.
Department of Ophthalmology, Zhuji People's Hospital of Zhejiang Province, 311800, Zhuji, China.
BMC Ophthalmol. 2021 Jan 19;21(1):49. doi: 10.1186/s12886-021-01809-6.
Tears in Schwartz-Matsuo syndrome are generally confirmed by preoperative ophthalmoscopic examination. A case of Schwartz-Matsuo syndrome with a tear detected by ultrasound biomicroscopy (UBM) and treated by UBM-guided scleral buckling was reported, and its mechanism was analysed.
A 40-year-old Chinese man presented with blurry vision and intermittent eye pain in his left eye for three days. The visual acuity of the left eye decreased from 20/20 to 20/40, and the intraocular pressure (IOP) fluctuated dramatically from 24.0 mmHg to 56.7 mmHg at the first visit. Gonioscopy revealed that the chamber angle remained open. A macula-involving inferior retinal detachment extending from 4:30 to 9:30 with no obvious causative break was observed through ophthalmoscopic examination. However, a single small tear was detected at the nonpigmented epithelium of pars plana of the ciliary body at approximately 7-8 o'clock by UBM. The loss of photoreceptor outer segments and ellipsoid zone and the existence of macular microcysts in the inner and outer nuclear layers were observed in the detached macula by optical coherence tomography. Then, he underwent successful scleral buckling guided by UBM. Three months later, the retina was flat with normal IOP, and the best corrected visual acuity of his left eye gradually improved to 20/25. UBM confirmed the closure of the tear.
Tear of the nonpigmented epithelium of the ciliary body is a rare condition associated with Schwartz-Matsuo syndrome. UBM plays a key role in detecting occult tears of the nonpigmented epithelium of the ciliary body, guiding scleral buckling surgery, and observing the closure of the tear postoperatively.
Schwartz-Matsuo 综合征的裂孔通常通过术前眼底检查来确诊。本文报告了一例超声生物显微镜（UBM）发现裂孔并经 UBM 引导巩膜扣带术治疗的 Schwartz-Matsuo 综合征病例，并分析其发病机制。
一名 40 岁的中国男性，因左眼视物模糊伴间歇性眼痛 3 天就诊。左眼视力从 20/20 下降至 20/40，眼压在首次就诊时从 24.0mmHg 波动至 56.7mmHg。房角镜检查发现房角开放。眼底镜检查发现黄斑下累及视网膜脱离，从 4:30 延伸至 9:30，未见明显裂孔。然而，UBM 检查发现睫状体平坦部无色素上皮处有单个小裂孔，约位于 7-8 点钟。光学相干断层扫描发现脱离的黄斑内层和外层核层存在光感受器外节和椭圆体带丢失以及黄斑微囊。随后，他接受了 UBM 引导的巩膜扣带术。3 个月后，视网膜平复，眼压正常，左眼最佳矫正视力逐渐提高至 20/25。UBM 证实裂孔已闭合。
睫状体无色素上皮的裂孔是一种罕见的 Schwartz-Matsuo 综合征相关病变。UBM 在检测睫状体无色素上皮隐匿性裂孔、引导巩膜扣带术以及观察术后裂孔闭合方面发挥着关键作用。
