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视盘小凹性黄斑病变:临床特征与治疗选择

Optic Pit Maculopathy: Clinical Features and Management Options.

作者信息

Iyer Prashanth G, Flynn Harry W, Fan Kenneth C, Berrocal Audina M, Goldhardt Raquel

机构信息

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.

出版信息

Curr Ophthalmol Rep. 2021 Dec;9(4):158-167. doi: 10.1007/s40135-021-00274-0. Epub 2021 Oct 7.

Abstract

PURPOSE OF REVIEW

In this article, we review the pathogenesis, clinical features, imaging modalities and latest management options for optic pit maculopathy (OPM).

RECENT FINDINGS

The pathogenesis of OPM remains to be unclear, but imaging tools such as optical coherence tomography (OCT) and OCT angiography are enhancing our knowledge. Observation continues to be the best management strategy for patients with good visual acuity, and many cases have demonstrated spontaneous resolution. For more advanced, progressive vision loss, treatment options involving vitrectomy can be considered and discussed with the patient. Supplementary techniques to vitrectomy have been reported in small studies with relative success such as glial tissue peeling, inverted internal limiting membrane flap, optic pit plugging, and retinal fenestration.

SUMMARY

While there are multiple treatment options available for OPM, there is no consensus on the technique and surgical timing. Individual patient factors and the risks-benefits of treatment must be taken into account in guiding management. Larger clinical trials will further assist in decision making for treating OPM.

摘要

综述目的

在本文中,我们回顾了视盘小凹黄斑病变(OPM)的发病机制、临床特征、影像学检查方法及最新治疗选择。

最新发现

OPM的发病机制尚不清楚,但光学相干断层扫描(OCT)和OCT血管造影等影像学工具正在增进我们的认识。对于视力良好的患者,观察仍是最佳治疗策略,许多病例已显示可自行缓解。对于更严重的进行性视力丧失,可考虑采用玻璃体切除术等治疗方案,并与患者进行讨论。在一些小型研究中报告了玻璃体切除术的辅助技术,如胶质组织剥离、倒置内界膜瓣、视盘小凹封堵和视网膜开窗术,取得了相对成功。

总结

虽然OPM有多种治疗选择,但在技术和手术时机上尚无共识。在指导治疗时,必须考虑个体患者因素以及治疗的风险和益处。更大规模的临床试验将进一步有助于指导OPM的治疗决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89bd/8845502/093a6ee24791/nihms-1757459-f0001.jpg

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Spontaneous resolution of optic pit maculopathy: an OCT report.视盘小凹黄斑病变的自然消退:一份光学相干断层扫描报告
Ther Adv Ophthalmol. 2020 Aug 26;12:2515841420950843. doi: 10.1177/2515841420950843. eCollection 2020 Jan-Dec.
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Management of double optic disc pit complicated by maculopathy.合并黄斑病变的双眼视盘小凹的治疗
Indian J Ophthalmol. 2020 Apr;68(4):663-665. doi: 10.4103/ijo.IJO_1114_19.
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Optic Disc Pit Maculopathy: A Review.视盘小凹黄斑病变:综述。
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