Department of Ophthalmology, University of Turin, Turin, Italy.
Eur J Ophthalmol. 2024 May;34(3):NP92-NP96. doi: 10.1177/11206721241234426. Epub 2024 Feb 26.
To report a case of pitchfork sign following pars plana vitrectomy for idiopathic epiretinal membrane.
Case report.
A 75-year-old man was referred to the surgical retina service due to a quantitative and qualitative decline in vision in the left eye (LE) for several months. Optical coherence tomography (OCT) examination revealed the presence of a stage III epiretinal membrane (ERM) according to the Govetto classification. Seven days after undergoing a 25-gauge pars plana vitrectomy (PPV) with ERM peeling and balanced salt solution (BSS) tamponade, OCT examination revealed the presence of the 'pitchfork sign' in the macular region, along with the detection of a choroidal neovascularization (CNV) through OCT-A examination. After receiving two monthly intravitreal anti-VEGF injections, a complete regression of the MNV was observed.
We reported, for the first time, the iatrogenic onset of the pitchfork sign following vitreoretinal surgery. This discovery highlights the unique presentation of the pitchfork sign in the context of surgical procedures, expanding our comprehension of its range of causes.
报告 1 例特发性视网膜内膜脱离行扁平部玻璃体切除术后出现叉状征。
病例报告。
1 例 75 岁男性,左眼(LE)视力定量和定性下降数月,转至手术视网膜科就诊。光学相干断层扫描(OCT)检查显示存在戈维托(Govetto)分类的 3 期内界膜(ERM)。在接受 25G 经平坦部玻璃体切除术(PPV)联合 ERM 剥除和平衡盐溶液(BSS)填充 7 天后,OCT 检查显示黄斑区出现“叉状征”,同时通过 OCT-A 检查发现脉络膜新生血管(CNV)。接受 2 个月每月 1 次抗 VEGF 眼内注射后,观察到 MNV 完全消退。
我们首次报告了玻璃体视网膜手术后叉状征的医源性出现。这一发现突出了手术过程中叉状征的独特表现,扩展了我们对其病因范围的理解。