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眼前节光学相干断层扫描在眼皮肤黑素细胞增多症(太田痣)浅层巩膜切除术手术规划中的应用:病例报告及文献综述

Utility of anterior segment optical coherence tomography in the surgical planning of superficial sclerectomy in oculodermal melanocytosis (nevus of Ota): A case report and review of literature.

作者信息

Mularoni Alessandro, Rania Laura, Forlini Matteo, Marcheggiani Eleonora Benedetta, Imburgia Aurelio

机构信息

Department of Ophthalmology, Istituto per La Sicurezza Sociale, San Marino Hospital, San Marino.

出版信息

Am J Ophthalmol Case Rep. 2021 Jul 23;23:101179. doi: 10.1016/j.ajoc.2021.101179. eCollection 2021 Sep.

Abstract

PURPOSE

to report the utility of Anterior Segment Optical Coherence Tomography (AS OCT) for planning superficial sclerectomy in a patient with nevus of Ota.

OBSERVATIONS

Oculodermal melanocytosis, also called nevus of Ota, is a benign pigmentary disorder that involves the skin innervated by the first and second branches of the trigeminal nerve. To reduce these black or brownish lesions, different surgical treatments have been reported, such as flipped scleral flap, sclera allograft and the grabbing method. Superficial sclerectomy is a recent technique that has proven effective in improving scleral pigmentation. Although this procedure allows the operating time to be reduced and results in a smoother scleral bed surface, it has a limitation, represented by the difficulty of estimating the depth of the sclerectomy: an inaccurate estimate or incorrect depth could cause an inadequate deep scleral dissection with excessive weakening of the sclera. We report a case of a 27-year-old patient with nevus of Ota undergoing superficial sclerectomy. The depth of scleral pigmentation was evaluated with AS OCT images before the surgery, allowing a superficial sclerectomy to be performed with a precalibrated diamond blade.

CONCLUSIONS AND IMPORTANCE

In oculodermal melanocytosis (nevus of Ota) the use of AS OCT images showing the depth of scleral pigmentation could lead to the most effective and safest surgical choice for each case.

摘要

目的

报告眼前节光学相干断层扫描(AS OCT)在太田痣患者浅表巩膜切除术规划中的应用。

观察结果

眼皮肤黑素细胞增多症,又称太田痣,是一种良性色素沉着疾病,累及三叉神经第一和第二分支支配的皮肤。为减少这些黑色或褐色病变,已报道了不同的手术治疗方法,如翻转巩膜瓣、巩膜同种异体移植和抓取法。浅表巩膜切除术是一种最近被证明对改善巩膜色素沉着有效的技术。虽然该手术可缩短手术时间并使巩膜床表面更光滑,但它有一个局限性,即难以估计巩膜切除术的深度:估计不准确或深度不正确可能导致深层巩膜剥离不足,巩膜过度变薄。我们报告一例27岁太田痣患者接受浅表巩膜切除术的病例。术前通过AS OCT图像评估巩膜色素沉着的深度,从而使用预先校准的金刚石刀片进行浅表巩膜切除术。

结论与意义

在眼皮肤黑素细胞增多症(太田痣)中,使用显示巩膜色素沉着深度的AS OCT图像可为每个病例带来最有效和最安全的手术选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f25d/8332660/576a31e8139b/gr1.jpg

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