Shipton Chloe Jennifer, Gilmour David Francis
Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, United Kingdom.
Case Rep Ophthalmol. 2022 Jun 9;13(2):429-434. doi: 10.1159/000519914. eCollection 2022 May-Aug.
A 44-year-old male presented with unilateral sudden onset reduced visual acuity. The optical coherence tomography (OCT) scan demonstrated submacular fluid with thickening and hyper-reflectivity of the outer retinal layers, together with subfoveal retinal pigment epithelial hyper-reflectivity corresponding to a small area of foveal interdigitation zone/ellipsoid zone (IZ/EZ) loss in the detached retina. An OCT 4 months later showed resolution of the submacular fluid, but the IZ/EZ loss persisted with thinning of the outer nuclear layer, resulting in a poor visual outcome. The clinical findings most likely represent a case of unilateral acute idiopathic maculopathy; however, the OCT features and poor visual outcome are not typical. Differential diagnoses include acute solar maculopathy, central serous chorioretinopathy, poppers maculopathy, whiplash maculopathy, and acute retinal pigment epitheliitis.
一名44岁男性因单眼视力突然下降前来就诊。光学相干断层扫描(OCT)显示黄斑下积液,视网膜外层增厚且高反射,同时黄斑下视网膜色素上皮高反射对应于脱离视网膜中一小片中央凹指状交叉区/椭圆体区(IZ/EZ)缺失。4个月后的OCT显示黄斑下积液消退,但IZ/EZ缺失持续存在,伴有外核层变薄,导致视力预后不佳。临床发现最有可能代表一例单侧急性特发性黄斑病变;然而,OCT特征和不良视力预后并不典型。鉴别诊断包括急性日光性黄斑病变、中心性浆液性脉络膜视网膜病变、吸食Poppers所致黄斑病变、挥鞭样黄斑病变和急性视网膜色素上皮炎。