Rana Harkaran S, Cox Anthony R, Biles Evan C, Broderick Kevin
Department of Ophthalmology, Walter Reed National Military Medical Center, Bethesda, MD, USA.
Medical University of South Carolina, College of Medicine, Charleston, SC, USA.
J Vitreoretin Dis. 2022 Mar 1;6(6):461-466. doi: 10.1177/24741264211062928. eCollection 2022 Nov-Dec.
We report a rare case of neurosensory retinal detachment (RD) in the setting of a giant retinal pigment epithelium (RPE) tear.
A 58-year-old man presented with a macula-involving RD in the left eye. Exam revealed a neurosensory detachment inferiorly and RPE abnormalities temporally. Optical coherence tomography showed a large RPE tear and detachment in the temporal macula contiguous with a neurosensory RD.
No clear etiology was identified and failure of conservative management led to vitrectomy with RD repair. Follow-up intravenous fluorescein angiography 3 months postoperatively showed a large RPE window defect.
RPE tears are common; however, concomitant neurosensory RD is rare. A thorough workup to determine treatable causative factors is necessary; in the event of idiopathic diagnosis, close follow-up is necessary to determine the need for surgery. Pars plana vitrectomy, external drainage of subretinal fluid, endolaser, and 5000-centistoke silicone oil placement were successful in this patient.
我们报告一例罕见的在巨大视网膜色素上皮（RPE）撕裂情况下发生的神经感觉性视网膜脱离（RD）病例。
一名58岁男性因左眼黄斑受累的RD就诊。检查发现下方存在神经感觉性脱离，颞侧有RPE异常。光学相干断层扫描显示颞侧黄斑区有一个大的RPE撕裂及脱离，与神经感觉性RD相连。
未明确病因，保守治疗失败后行玻璃体切除术及RD修复术。术后3个月的随访静脉荧光素血管造影显示有一个大的RPE窗样缺损。
RPE撕裂很常见；然而，合并神经感觉性RD则很罕见。有必要进行全面检查以确定可治疗的病因；如果诊断为特发性，需要密切随访以确定是否需要手术。该患者行玻璃体平坦部切除术、视网膜下液外引流、眼内激光光凝及注入5000厘沲硅油治疗成功。
