Liu Zhigao, Wang Shuya, Wang Yu, Ma Aihua, Zhao Bojun
First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China.
Department of Ophthalmology, Jinan Aier Eye Hospital, Jinan, China.
Front Med (Lausanne). 2021 Dec 24;8:793054. doi: 10.3389/fmed.2021.793054. eCollection 2021.
This study aimed to report a case of vitrectomy with peeling the internal limiting membrane for the treatment of macular hole (MH) following ruptured retinal arterial macroaneurysm (RAMA). A 65-year-old woman noticed a sudden decrease in vision in the left eye. She had no other ocular problems apart from a mild cataract in both eyes before. Her best-corrected visual acuity (BCVA) was 20/33 in the right eye, and 6/100 in the left eye. Fluorescein angiography (FFA) showed a retinal arterial macroaneurysm with telangiectatic retinal vascular changes in the inferior temporal macular region. Optical coherence tomography (OCT) examination demonstrated the presence of subretinal hemorrhage extending into the foveal area and incomplete posterior vitreous detachment. Because of the presence of submacular hemorrhage, some medicine was administrated and the patient was followed up. Then, 5 months later, the hemorrhage was absorbed. OCT examination exhibited a full-thickness MH with a macular epiretinal membrane. The size of the MH was 722 μm in diameter. She was then given a standard three-port pars plana vitrectomy (PPV), along with peeling of the internal limiting membrane (ILM) and filling the vitreous cavity with air. Anatomic closure of the MH was achieved after 4 weeks of the surgery by the examination of OCT. The BCVA was improved to 15/100. This case expanded our knowledge of the association of MH secondary to ruptured RAMA. We reported a case with successful surgical closure of the MH and improvement of BCVA.
本研究旨在报告1例视网膜动脉大动脉瘤（RAMA）破裂后行玻璃体切除术联合内界膜剥除术治疗黄斑裂孔（MH）的病例。一名65岁女性左眼视力突然下降。她之前除双眼轻度白内障外无其他眼部问题。其右眼最佳矫正视力（BCVA）为20/33，左眼为6/100。荧光素血管造影（FFA）显示颞下黄斑区有一个视网膜动脉大动脉瘤伴视网膜血管扩张改变。光学相干断层扫描（OCT）检查显示视网膜下出血延伸至黄斑中心凹区域且玻璃体后脱离不完全。由于存在黄斑下出血，给予了一些药物治疗并对患者进行随访。5个月后，出血吸收。OCT检查显示为全层黄斑裂孔伴黄斑视网膜前膜。黄斑裂孔直径为722μm。随后对其进行了标准的三通道平坦部玻璃体切除术（PPV），同时剥除内界膜（ILM）并向玻璃体腔注入空气。术后4周经OCT检查黄斑裂孔实现了解剖学闭合。最佳矫正视力提高到了15/100。该病例扩展了我们对RAMA破裂继发黄斑裂孔相关性的认识。我们报告了1例成功手术闭合黄斑裂孔并提高最佳矫正视力的病例。
