Dept. of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, Karnataka, India.
Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, 203 Lothrop Street, Suite 800, Pittsburg, PA 15213, USA.
Eur J Ophthalmol. 2024 Nov;34(6):NP48-NP53. doi: 10.1177/11206721241272249. Epub 2024 Aug 6.
To describe the evolution of posterior staphyloma-induced serous maculopathy (PSISM) in a patient with myopic tilted disc syndrome and its treatment with subthreshold micro pulse laser (SMPL) therapy.
A 38-year-old male, diagnosed previously with classical features of myopic tilted disc syndrome presented to the retina clinic after 5 years from the initial presentation with blurred vision in the right eye for 6 months, visual acuity of 6/15 and findings of serous macular detachment (SMD) and subretinal precipitates at the upper margin of the posterior staphyloma. Retinal imaging ruled out other causes of SMD such as chronic central serous chorioretinopathy, myopic macular neovascularisation and dome shaped macula. A diagnosis of PSISM was confirmed. The left eye fundus and macula was normal.
Confluent SMPL burns were applied across the SMD. The serous maculopathy resolved over a period of 2 months and visual acuity improved to 6/9. No recurrence of SMD was noted even after 14 months post SMPL.
PSISM develops gradually in eyes with myopic titled disc syndrome. SMPL is a viable therapeutic option in the management of PSISM and should be considered early in the treatment options.
描述近视性倾斜盘综合征患者后葡萄肿引起的浆液性黄斑病变（PSISM）的演变及其亚阈微脉冲激光（SMPL）治疗。
一名 38 岁男性，此前被诊断为典型的近视性倾斜盘综合征，在最初表现为右眼视力模糊 6 个月后 5 年就诊于视网膜诊所，右眼视力为 6/15，发现后葡萄肿上方有浆液性黄斑脱离（SMD）和视网膜下沉淀物。视网膜成像排除了其他 SMD 原因，如慢性中心性浆液性脉络膜视网膜病变、近视性黄斑新生血管和盘状黄斑。确诊为 PSISM。左眼眼底和黄斑正常。
在 SMD 上应用了融合的 SMPL 光斑。浆液性黄斑病变在 2 个月内消退，视力提高至 6/9。即使在 SMPL 治疗后 14 个月，也没有发现 SMD 再次发生。
PSISM 在近视性倾斜盘综合征的眼中逐渐发展。SMPL 是治疗 PSISM 的可行治疗选择，应在治疗选择中早期考虑。
