Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, India.
Department of Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, 203 Lothrop Street, Suite 800, Pittsburg, PA, 15213, USA.
BMC Ophthalmol. 2024 Aug 20;24(1):357. doi: 10.1186/s12886-024-03636-x.
In this report, we describe a case of proliferative diabetic retinopathy that developed into exudative changes confusing with central serous chorioretinopathy (CSCR) following extensive endolaser pan retinal photocoagulation.
A 49-year-old male patient with diabetic retinopathy in both eyes presented with vitreous hemorrhage and 6/60 visual acuity in his left eye. Optical coherence tomography (OCT) scans at presentation revealed serous PEDs in both eyes. On day 10 after vitreoretinal surgery and complete peripheral endolaser PRP for the left eye, there was serous retinal detachment (SRD) and an increase in PED heights, mimicking CSCR. No additional treatment was considered. At the three-week post-operative visit, OCT scans revealed that the SRD had resolved and the PED heights had decreased without rupture. At the final follow-up visit, 12 weeks after surgery, the SRD had not recurred, and the PEDs had stabilized. Despite no additional ocular therapy for the right eye, the serous PED height had decreased. The choroidal thickness (CT) at the fovea at various points during the follow-up visits revealed a reduction in both eyes.
This case demonstrated the course of SRD, PED, and CT following extensive PRP. These changes may be associated with intraocular VEGF changes. In the presence of SRD and serous PED, the PED morphology may help differentiate the condition from CSCR. Although caution should be exercised when performing PRP during surgery or as an outpatient procedure, the SRD usually resolves without problem.
在本报告中,我们描述了一例增殖性糖尿病性视网膜病变病例,该病例在广泛的全视网膜光凝后,出现渗出性改变,与中心性浆液性脉络膜视网膜病变(CSCR)相混淆。
一名 49 岁男性,双眼均患有糖尿病性视网膜病变,左眼玻璃体出血,视力为 6/60。就诊时的光学相干断层扫描(OCT)显示双眼均有浆液性 PED。左眼玻璃体视网膜手术后第 10 天,行完全周边部光凝后,出现浆液性视网膜脱离(SRD)和 PED 高度增加,类似于 CSCR。未考虑进一步治疗。术后 3 周,OCT 扫描显示 SRD 已缓解,PED 高度降低且未破裂。最终随访时,即手术后 12 周,SRD 未复发,PED 稳定。尽管右眼未进行额外的眼部治疗,但浆液性 PED 高度降低。在随访过程中,各时间点的黄斑区脉络膜厚度(CT)显示双眼 CT 均减少。
本病例展示了广泛 PRP 后 SRD、PED 和 CT 的变化过程。这些变化可能与眼内 VEGF 变化有关。在存在 SRD 和浆液性 PED 的情况下,PED 形态有助于将其与 CSCR 相区分。尽管在手术期间或作为门诊手术进行 PRP 时应谨慎,但 SRD 通常会自行消退,不会产生问题。