Vitreo-Retina, LV Prasad Eye Institute, Hyderabad, India.
Vitreo-Retina, LV Prasad Eye Institute, Hyderabad, India
BMJ Case Rep. 2021 Feb 1;14(2):e237635. doi: 10.1136/bcr-2020-237635.
A 44-year-old woman presented with decreased vision in both eyes. The retina in both eyes had drusen distributed along vascular arcades, central macula and in peripapillary region. Macula had pigmented scarring and exudation. Fundus autofluorescence showed drusen. Optical coherence tomography showed drusen, subretinal and intraretinal fluid. Fundus fluorescein and indocyanine green angiography showed drusen, retinal pigment epithelial atrophy and vascular network. Younger age at presentation, bilateral symmetry, typical distribution of drusen along the arcades in a radiating pattern, peripapillary involvement, scarring and atrophy at macula were suggestive of doyne honeycomb retinal dystrophy. The reduced vision was due to macular atrophy and an active choroidal neovascular membrane. The patient was treated with antivascular endothelial growth factor injections for choroidal neovascular membrane. Our case highlights the importance of pattern recognition and multimodal imaging for diagnosing the type of macular dystrophy as doyne honeycomb retinal dystrophy, while simultaneously managing choroidal neovascular membrane.
一位 44 岁女性因双眼视力下降就诊。双眼视网膜沿血管弓、中心凹和视盘周围分布有玻璃膜疣。黄斑区有色素性瘢痕和渗出。眼底自发荧光显示玻璃膜疣。光学相干断层扫描显示玻璃膜疣、视网膜下和视网膜内液。眼底荧光素和吲哚青绿血管造影显示玻璃膜疣、视网膜色素上皮萎缩和血管网。起病年龄较轻、双侧对称、玻璃膜疣呈放射状沿血管弓分布、视盘周围受累、黄斑区瘢痕和萎缩提示弥漫性格子状视网膜营养不良。视力下降是由于黄斑萎缩和脉络膜新生血管膜。患者因脉络膜新生血管膜接受抗血管内皮生长因子注射治疗。本病例强调了模式识别和多模态成像在诊断弥漫性格子状视网膜营养不良等黄斑营养不良类型以及同时管理脉络膜新生血管膜中的重要性。
