Department of Retina Vitreous, Aravind Eye Hospital, Madurai, Tamil Nadu, India.
Department of Retina Vitreous, Aravind Eye Hospital, Madurai, Tamil Nadu, India
BMJ Case Rep. 2022 Aug 12;15(8):e249564. doi: 10.1136/bcr-2022-249564.
Pre-macular haemorrhage (PMH) can cause profound visual loss. Some surgeons prefer neodymium-doped yttrium aluminium garnet (Nd:YAG) hyaloidotomy as the first line of treatment due to being an easy technique and having a high success rate. However, the use of high energy close to the fovea can lead to various macular complications. We present a case of a patient who presented with PMH secondary to anaemic retinopathy. He underwent Nd:YAG laser hyaloidotomy, but developed a full-thickness macular hole. He further underwent vitrectomy and a type 1 closure was achieved. However, the visual gain was poor due to the large hole size and the collateral thermal damage. The hole may not close spontaneously, thus requiring surgical intervention. The surgical outcome of these holes depends on the size of the hole and the collateral thermal damage caused during the laser procedure.
黄斑前出血 (PMH) 可导致严重的视力丧失。一些外科医生由于手术简单且成功率高而首选钕掺杂钇铝石榴石 (Nd:YAG) 玻璃体切割术作为一线治疗方法。然而，在靠近黄斑的位置使用高能量可能会导致各种黄斑并发症。我们报告了一例因贫血性视网膜病变引起 PMH 的患者。他接受了 Nd:YAG 激光玻璃体切割术，但出现了全层黄斑裂孔。他进一步接受了玻璃体切除术，实现了 1 型闭合。然而，由于孔的尺寸较大以及热损伤的影响，视力提高不佳。该孔可能不会自行闭合，因此需要手术干预。这些孔的手术结果取决于孔的大小以及激光手术过程中造成的热损伤程度。
