University of Texas Medical Branch, 700 University Boulevard, Galveston, Tx, 77555, USA.
BMC Ophthalmol. 2021 May 17;21(1):221. doi: 10.1186/s12886-021-01984-6.
Report a rare case of retinal capillary macroaneurysm with associated subretinal fluid.
A 71-year-old male underwent full ophthalmic examination including Optical Coherence Tomography (OCT), Fluorescein Angiography (FA). Fundus examination showed moderate non-proliferative diabetic retinopathy of both eyes with scattered microaneurysms. On initial visit, FA displayed a hyperfluorescent lesion with leakage on late frames in the left eye. OCT revealed the lesion to be spheroid with a hyperreflective wall and hyporeflective lumen in the inner retina, corresponding to a capillary macroaneurysm. Intraretinal cystic fluid surrounded the lesion. On subsequent visit 7 months later, subretinal fluid in the location of the capillary macroaneurysm was noted on OCT. Vision was maintained at 20/30-2 OD, 20/40 OS throughout. No treatment was necessary.
Subretinal fluid from the capillary macroaneurysm likely developed from its juxtafoveal location and discontinuity of the external limiting membrane (ELM); a barrier preventing flow of intraretinal fluid to the outer retina.
报告一例罕见的视网膜毛细血管巨型动脉瘤伴网膜下积液。
一名 71 岁男性接受了全面眼科检查，包括光学相干断层扫描（OCT）和荧光素血管造影（FA）。眼底检查显示双眼中度非增生性糖尿病性视网膜病变，伴有散在的微动脉瘤。初次就诊时，FA 显示左眼晚期出现高荧光病变伴渗漏。OCT 显示病变呈类球体，视网膜内层有高反射壁和低反射腔，对应于毛细血管巨型动脉瘤。病变周围有视网膜内囊性积液。7 个月后复诊时，OCT 显示在毛细血管巨型动脉瘤的位置有网膜下积液。视力始终保持在右眼 20/30-2，左眼 20/40。无需治疗。
网膜下液可能是由于巨型动脉瘤位于黄斑旁和外部界膜（ELM）不连续，这是一种阻止视网膜内液流向外视网膜的屏障。
