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玻璃体黄斑粘连松解术后星状非遗传性特发性黄斑视网膜劈裂的消退

Stellate nonhereditary idiopathic foveomacular retinoschisis resolution after vitreomacular adhesion release.

作者信息

Machado Nogueira Thiago, de Souza Costa Daniel, Isenberg Jordan, Rezende Flavio A

机构信息

Department of Ophthalmology, University of Sao Paulo, Sao Paulo, Brazil.

Department of Ophthalmology, University of Montreal, Montreal, Quebec, Canada.

出版信息

Am J Ophthalmol Case Rep. 2021 Jun 19;23:101153. doi: 10.1016/j.ajoc.2021.101153. eCollection 2021 Sep.

Abstract

PURPOSE

To present a case of stellate nonhereditary idiopathic foveomacular retinoschisis (SNIFR) resolution associated with vitreomacular adherence (VMA) release and propose a potential contributing association between SNIFR and vitreomacular interactions.

OBSERVATIONS

A 67-year-old female patient was diagnosed and followed for SNIFR in OD with spectral-domain optical coherence tomography (SD-OCT) scans at presentation and subsequent visits at 3, 6, 16 and 22 months. VMA and foveomacular retinoschisis remained unchanged on SD-OCT during the first 6 months of the follow-up. At 16-month follow-up visit, SD-OCT revealed VMA release and an important improvement of the macular schisis. At 22 months of follow-up, SNIFR cavities completely resolved in the presence of posterior hyaloid separation from the macular area without any adjunct treatment. The authors could not identify any other possible cause to justify the resolution of SNIFR other than VMA release in this case. Patient did not undergo any treatment for OD other than phacoemulsification 3 months after initial visit.

CONCLUSION

The present case illustrates with SD-OCT scans a possible association between SNIFR resolution and VMA release, highlighting a potential tractional component of the posterior vitreous on the internal limiting membrane and consequent glial cells stretching with schisis formation.

摘要

目的

报告一例与玻璃体黄斑粘连(VMA)松解相关的星状非遗传性特发性黄斑视网膜劈裂(SNIFR)消退病例,并提出SNIFR与玻璃体黄斑相互作用之间可能存在的关联。

观察结果

一名67岁女性患者因右眼SNIFR就诊,初诊及随后3个月、6个月、16个月和22个月随访时均行光谱域光学相干断层扫描(SD-OCT)检查。随访的前6个月,SD-OCT显示VMA和黄斑视网膜劈裂无变化。在16个月随访时,SD-OCT显示VMA松解,黄斑劈裂有显著改善。在22个月随访时,在黄斑区后玻璃体脱离的情况下,SNIFR腔完全消退,未进行任何辅助治疗。在该病例中,除VMA松解外,作者未发现其他可能导致SNIFR消退的原因。患者在初诊3个月后除行超声乳化白内障吸除术外,未对右眼进行任何其他治疗。

结论

本病例通过SD-OCT扫描说明了SNIFR消退与VMA松解之间可能存在的关联,突出了玻璃体后皮质对视网膜内界膜的潜在牵拉作用以及随之而来的胶质细胞拉伸与劈裂形成的关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/294c/8237522/20b1b796e9df/gr1.jpg

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