Shaimova V A, Islamova G R, Trubilin V N, Dmukh T S, Kuchkildina S Kh, Shaimov T B, Shaimov R B, Kravchenko T G, Fomin A V
Academy of postgraduate education of the Federal Scientific and Clinical Center of Specialized Medical Care and Medical Technologies, Moscow, Russia.
OOO Center Zreniya, Chelyabinsk, Russia.
Vestn Oftalmol. 2023;139(1):93-98. doi: 10.17116/oftalma202313901193.
Certain late peripheral ruptures after acute posterior vitreous detachment (PVD) may remain undetected during the initial examination of the fundus due to the presence of vitreous hemorrhages and other factors, but they can lead to rhegmatogenic retinal detachment in the future. Hence, it is necessary to conduct an additional thorough examination using optical coherence tomography (OCT) of the vitreoretinal interface periphery in the presence of tear predictors: retinal and vitreal hemorrhages, vitreous pigment cells ("tobacco dust") in the anterior segment of the vitreous body, as well as hyper-reflective dots ("starry sky") in the vitreous body according to OCT scans of patients with acute symptomatic detachment of the hyaloid membrane. The article presents the case of a patient with a clinically imperceptible flap tear detected during acute posterior vitreous detachment. Widefield OCT of the vitreoretinal interface was performed by "sliding" from the center to the periphery of the retina, and revealed a flap tear located next to a dot retinal hemorrhage. OCT scanning of the retinal periphery is an effective modern diagnostic method in the ophthalmological clinical practice.
急性玻璃体后脱离(PVD)后的某些晚期周边部裂孔,由于存在玻璃体积血及其他因素,在眼底初次检查时可能未被发现,但它们未来可能导致孔源性视网膜脱离。因此,在存在裂孔预测因素时,有必要使用光学相干断层扫描(OCT)对玻璃体视网膜界面周边部进行额外的全面检查,这些因素包括视网膜和玻璃体积血、玻璃体前段的玻璃体色素细胞(“烟草尘”)以及根据急性症状性玻璃体膜脱离患者的OCT扫描显示的玻璃体内高反射点(“星空”)。本文介绍了一名在急性玻璃体后脱离期间检测到临床难以察觉的瓣状裂孔的患者病例。通过从视网膜中心向周边“滑动”进行玻璃体视网膜界面的广角OCT检查,发现一个位于点状视网膜出血旁的瓣状裂孔。视网膜周边部的OCT扫描是眼科临床实践中一种有效的现代诊断方法。