Zhang Wei, Peng Xiao-Yan
Beijing Ophthalmology and Visual Science Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China.
World J Clin Cases. 2022 Jul 16;10(20):6966-6973. doi: 10.12998/wjcc.v10.i20.6966.
To report an unusual case of bilateral optic disc coloboma associated with macular retinoschisis in the left eye.
A 37-year-old woman presented with complaints of blurred and distorted vision in her left eye for more than 1 year. Fundus examination demonstrated choroidal atrophy around the optic disc in both eyes, with a cup-to-disc ratio of 0.9. Serous retinal detachment in the macular area of the left eye. Left eye macular blood flow imaging optical coherence tomography (Angio-OCT) showed macular retinal serous cleavage. En-face OCT showed that the canal gully-like structure formed by the defect of the optic disc nerve fiber layer between the optic disc and macula, serous detachment area was connected with the enlarged optic disc coloboma through the canal gully-like structure, and the fluid leaked from the enlarged and thinned optic disc coloboma into the retinal layer of the macular area. Patients with optic disc abnormalities and macular degeneration must be monitored appropriately. During the follow-up period, the use of optic disc stereography and 3D-OCT, en-face, and Angio-OCT imaging can clarify the correlation between macular retinoschisis and optic disc coloboma.
Macular retinoschisis may be owing to the combined force of disc edge loss, enlarged optic disc coloboma, the canal gully-like structure formed by the defect of the nerve fiber layer around the optic disc, and the traction of the posterior vitreous cortex.
报告一例罕见的双眼视神经盘缺损合并左眼黄斑视网膜劈裂的病例。
一名37岁女性，因左眼视力模糊和视物变形1年余就诊。眼底检查显示双眼视神经盘周围脉络膜萎缩，杯盘比为0.9。左眼黄斑区浆液性视网膜脱离。左眼黄斑血流成像光学相干断层扫描（Angio-OCT）显示黄斑视网膜浆液性劈裂。正面OCT显示视神经盘与黄斑之间视神经盘神经纤维层缺损形成的沟状结构，浆液性脱离区域通过沟状结构与扩大的视神经盘缺损相连，液体从扩大变薄的视神经盘缺损渗漏到黄斑区视网膜层。对视神经盘异常和黄斑变性患者必须进行适当监测。在随访期间，使用视神经盘立体摄影和3D-OCT、正面和Angio-OCT成像可以明确黄斑视网膜劈裂与视神经盘缺损之间的相关性。
黄斑视网膜劈裂可能是由于视盘边缘缺失、视神经盘缺损扩大、视神经盘周围神经纤维层缺损形成的沟状结构以及玻璃体后皮质的牵引共同作用所致。
