Mahmoudzadeh Raziyeh, Williamson John E, Salabati Mirataollah, Soares Rebecca R, Gupta Omesh P, Regillo Carl D, Ho Allen C, Hsu Jason
Mid Atlantic Retina, Retina Service of Wills Eye Hospital, Philadelphia, PA, USA.
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
J Vitreoretin Dis. 2023 Nov 10;8(1):101-104. doi: 10.1177/24741264231208254. eCollection 2024 Jan-Feb.
To describe the clinical course and optical coherence tomography (OCT) features of patients with spontaneous reattachment of macula-off tractional retinal detachments (TRDs). Findings on clinical examination and OCT were evaluated. Four eyes of 4 patients with a history of macula-off TRD secondary to diabetic retinopathy (n = 3) or sickle cell retinopathy (n = 1) were included. OCT confirmed spontaneous resolution of the macular RD without complete posterior vitreous separation in all eyes. The median (interquartile range [IQR]) time from TRD diagnosis to OCT-confirmed foveal reattachment was 6 months (10.25; range, 1-12 months). The median logMAR visual acuity (VA) at the time of macula-off TRD was 0.544 (IQR, 0.452; Snellen 20/70), which improved to 0.350 (IQR, 0.156; Snellen 20/45), with reattachment characterized by OCT ( = .068). Nonsurgical spontaneous retinal reattachment and significant VA improvement can occur in eyes with a TRD, albeit rarely. In these cases, no OCT evidence of posterior vitreous separation was found, suggesting that some relaxation of the contractile fibrovascular membranes occurred.
描述黄斑脱离型牵拉性视网膜脱离（TRD）自发复位患者的临床病程及光学相干断层扫描（OCT）特征。评估临床检查及OCT结果。纳入4例患者的4只眼，这些患者既往有糖尿病性视网膜病变（n = 3）或镰状细胞性视网膜病变（n = 1）继发的黄斑脱离型TRD病史。OCT证实所有患眼黄斑视网膜脱离均自发消退，且均无完全性玻璃体后脱离。从TRD诊断至OCT证实黄斑中心凹复位的中位（四分位间距[IQR]）时间为6个月（10.25；范围1 - 12个月）。黄斑脱离型TRD时的中位logMAR视力（VA）为0.544（IQR，0.452；Snellen 20/70），OCT证实复位后改善至0.350（IQR，0.156；Snellen 20/45）（P = 0.068）。TRD患眼可出现非手术性视网膜自发复位及显著的视力改善，尽管较为罕见。在这些病例中，未发现OCT显示玻璃体后脱离的证据，提示收缩性纤维血管膜出现了某种程度的松弛。
