Chaves Leandro, Costa Julian, Bastos Thaís, Albuquerque Marina, Scott Ingrid, Jorge Rodrigo
Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA.
Arq Bras Oftalmol. 2023 Oct 13;86(5):e20230066. doi: 10.5935/0004-2749.20230066. eCollection 2023.
The study aimed to describe anatomic and visual outcomes associated with perfluoropropane intravitreal injection followed by laser treatment for macular retinal detachment secondary to optic disc pit.
A single-center, retrospective study. Medical records of all patients treated at a tertiary retina referral center were evaluated between 2011 and 2018 for congenital optic disc pit-associated macular detachment with 0.3 ml 100% perfluoropropane intravitreal injection followed by retinal laser photocoagulation along the temporal optic disc margin as the initial treatment.
Six patients with optic disc pit-associated macular detachment were identified, with postoperative follow-up ranging from 13 to 52 months (mean: 28 months). Spectral domain optical coherence tomography (SD-OCT) showed complete fluid resolution without recurrence in five of the six cases. Four cases showed complete reabsorption after Intravitreal perfluoropropane plus laser, one patient needed an extra procedure (pars plana vitrectomy with inner limiting membrane peeling and pedicle flap inversion over the temporal optic disc margin) to achieve complete fluid reabsorption, and one patient had persistent intraretinal fluid and denied additional surgeries. The time between the initial procedure and total fluid reabsorption varied from 6.5 to 41 months (mean: 19.5 months). Best-corrected visual acuity improved after surgery on the last follow-up visit in all cases.
100% perfluoropropane intravitreal injection followed by photocoagulation along temporal optic disc margin was associated with anatomic and visual improvement in most cases, representing an alternative treatment approach for optic disc pit-associated macular detachment.
本研究旨在描述全氟丙烷玻璃体内注射联合激光治疗继发于视盘小凹的黄斑视网膜脱离的解剖学和视觉效果。
一项单中心回顾性研究。对2011年至2018年期间在一家三级视网膜转诊中心接受治疗的所有患者的病历进行评估，这些患者患有先天性视盘小凹相关的黄斑脱离，初始治疗为玻璃体内注射0.3 ml 100%全氟丙烷，随后沿颞侧视盘边缘进行视网膜激光光凝。
确定了6例视盘小凹相关的黄斑脱离患者，术后随访时间为13至52个月（平均：28个月）。光谱域光学相干断层扫描（SD-OCT）显示，6例中有5例积液完全消退且无复发。4例在玻璃体内注射全氟丙烷联合激光治疗后积液完全吸收，1例患者需要额外进行手术（经睫状体平坦部玻璃体切除术、内界膜剥除术以及颞侧视盘边缘蒂瓣翻转术）以实现积液完全吸收，1例患者视网膜内持续存在积液且拒绝进一步手术。首次手术至积液完全吸收的时间为6.5至41个月（平均：19.5个月）。所有病例在最后一次随访时术后最佳矫正视力均有改善。
玻璃体内注射100%全氟丙烷联合沿颞侧视盘边缘进行光凝在大多数情况下可改善解剖结构和视觉功能，是视盘小凹相关黄斑脱离的一种替代治疗方法。
