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青光眼引流装置囊与脉络膜上腔之间的巩膜沟通,模拟无色素性脉络膜黑色素瘤。

Scleral communication between Glaucoma drainage device capsule and the suprachoroidal space simulating amelanotic choroidal melanoma.

作者信息

Queiroz Diego, Lustosa Gustavo Porto, Mascato Diego, Morales Melina Correia, Fernandes Arthur Gustavo, Fernandes Rodrigo Antonio Brant

机构信息

Ophthal Hospital Especializado Ltda, São Paulo, SP, Brasil.

Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.

出版信息

Arq Bras Oftalmol. 2022 May 9;86(6). doi: 10.5935/0004-2749.20230073.

DOI:10.5935/0004-2749.20230073
PMID:35544943
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11826707/
Abstract

This is a case report involving a 56-year-old male patient with a history of pars plana vitrectomy due to a rhegmatogenous retinal detachment in the right eye that resulted in the implantation of a drainage device after the patient developed secondary glaucoma. Two years after the device's implantation, the patient was referred to our care as his visual acuity had decreased to 20/200 (1.00 LogMAR). At the fundus evaluation, a choroidal amelanotic elevation was observed at the upper temporal equator, and a potential diagnosis was made of amelanotic choroidal melanoma. The ultrasound exam visualized the patient's implanted superotemporal justabulbar drainage device, which revealed a transscleral communication from the plate fibrocapsular's draining space to the suprachoroidal space (fistula). The ultrasound also revealed a focal pocket of choroidal detachment in the patient's superotemporal region, simulating an amelanotic choroidal melanoma. A new pars plana vitrectomy was performed to remove the internal limiting membrane without repercussions at the fistula site. The patient's recovery progressed well, and he regained a visual acuity of 20/70 (0.55 LogMAR). To the best of our knowledge, this is the first case report of this condition.

摘要

这是一例病例报告,患者为一名56岁男性,有右眼孔源性视网膜脱离行玻璃体切除术病史,术后继发青光眼并植入了引流装置。该装置植入两年后,患者因视力下降至20/200(1.00 LogMAR)前来我院就诊。眼底检查时,在颞上赤道部观察到脉络膜无黑色素性隆起,初步诊断为无黑色素性脉络膜黑色素瘤。超声检查显示患者颞上球旁植入的引流装置,发现从板纤维囊引流间隙到脉络膜上腔存在经巩膜通道(瘘管)。超声还显示患者颞上区域有局限性脉络膜脱离区,类似无黑色素性脉络膜黑色素瘤。遂行再次玻璃体切除术以切除内界膜,瘘管部位未受影响。患者恢复良好,视力恢复至20/70(0.55 LogMAR)。据我们所知,这是该病症的首例病例报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3305/11826707/4a412d6e07fb/abo-86-06-e2023-0073-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3305/11826707/a6e588c03e34/abo-86-06-e2023-0073-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3305/11826707/e475fb284e2d/abo-86-06-e2023-0073-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3305/11826707/fa2c6284eb3a/abo-86-06-e2023-0073-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3305/11826707/4a412d6e07fb/abo-86-06-e2023-0073-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3305/11826707/a6e588c03e34/abo-86-06-e2023-0073-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3305/11826707/e475fb284e2d/abo-86-06-e2023-0073-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3305/11826707/fa2c6284eb3a/abo-86-06-e2023-0073-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3305/11826707/4a412d6e07fb/abo-86-06-e2023-0073-g04.jpg

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本文引用的文献

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Int J Retina Vitreous. 2020 Apr 9;6:7. doi: 10.1186/s40942-020-00210-7. eCollection 2020.
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Risk Factors for Choroidal Detachment After Ahmed Valve Implantation in Glaucoma Patients.青光眼患者 Ahmed 阀植入术后脉络膜脱离的危险因素。
Am J Ophthalmol. 2020 Mar;211:105-113. doi: 10.1016/j.ajo.2019.10.035. Epub 2019 Nov 13.
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The Choice of Drainage Device in Complicated Glaucomas: Comparing Ahmed and Baerveldt Implants.
复杂性青光眼引流装置的选择:比较艾哈迈德和贝尔维尔德特植入物
In Vivo. 2019 May-Jun;33(3):911-916. doi: 10.21873/invivo.11558.
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Rhegmatogenous retinal detachment in a patient with choroidal melanoma simulating choroidal detachment: a case report.脉络膜黑色素瘤患者模拟脉络膜脱离的孔源性视网膜脱离:一例报告
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Complications of glaucoma drainage device surgery: a review.青光眼引流装置手术的并发症:综述
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