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干性黄斑变性病程中神经感觉层视网膜脱离合并视网膜色素上皮与脉络膜分离——病例报告

Neurosensory retina detachment combined with retinal pigment epithelium separation from the choroid in the course of dry macular degeneration - A case report.

作者信息

Gawęcki Maciej, Grzybowski Andrzej

机构信息

Dobry Wzrok Ophthalmological Clinic, Zabi Kruk 10, 80-402, Gdańsk, Poland.

Department of Ophthalmology, University of Warmia and Mazury, Oczapowskiego 2, 10-719, Olsztyn, Poland.

出版信息

Heliyon. 2024 Aug 20;10(16):e36246. doi: 10.1016/j.heliyon.2024.e36246. eCollection 2024 Aug 30.

DOI:10.1016/j.heliyon.2024.e36246
PMID:39253240
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11382019/
Abstract

of advanced diagnostic methods shed the light on the variable course of age-related macular degeneration (AMD). Despite establishing AMD classifications used in clinical practice, there are still forms of AMD that do not fit into these systems. The case report presents a rare evolution of non-neovascular form of AMD presenting at baseline as large soft drusen. Within the 5 years of observation one eye with such form of AMD transformed to retinal pigment epithelial detachment and subsequently simultaneous separation of the neurosensory retina and the choroid from the RPE. As a result, on the spectral domain optical coherence tomography scan, the case presented with lone line of the RPE neighbored by subretinal fluid from the inner side and choroidal excavation from the outside. Macular neovascularization was excluded at each timepoint of the follow-up. During 2.5 years of observation post the onset of RPE separation, the case remained stable with maintained visual acuity at 0.25 Snellen and lack of progression to wet form of AMD. Further observation is needed to fully assess the eye's potential for visual preservation in the long term.

摘要

先进的诊断方法揭示了年龄相关性黄斑变性(AMD)的多变病程。尽管已经确立了临床实践中使用的AMD分类,但仍有一些AMD形式不适合这些系统。该病例报告展示了一种罕见的非新生血管性AMD的演变过程,其基线表现为大的软性玻璃膜疣。在5年的观察期内,一只患有这种AMD形式的眼睛转变为视网膜色素上皮脱离,随后神经感觉视网膜和脉络膜同时与RPE分离。结果,在光谱域光学相干断层扫描中,该病例表现为RPE的单独一条线,内侧邻近视网膜下液,外侧为脉络膜凹陷。在随访的每个时间点均排除了黄斑新生血管形成。在RPE分离开始后的2.5年观察期内,该病例保持稳定,视力维持在Snellen 0.25,且未进展为湿性AMD。需要进一步观察以全面评估该眼长期视觉保留的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed4f/11382019/79a9b5e53f98/gr9.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed4f/11382019/fb891840f2c6/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed4f/11382019/3f08248248b4/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed4f/11382019/55f994f3a235/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed4f/11382019/79a9b5e53f98/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed4f/11382019/656f3006a8c1/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed4f/11382019/2afbb33959bd/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed4f/11382019/cc6e1fad7328/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed4f/11382019/8b7e1d1c8828/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed4f/11382019/b33cf05389ef/gr5.jpg
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本文引用的文献

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Focal Choroidal Excavation: Epidemiology, Clinical Characteristics and Multimodal Imaging Findings.局限性脉络膜凹陷:流行病学、临床特征及多模态影像学表现
Diagnostics (Basel). 2023 Feb 7;13(4):602. doi: 10.3390/diagnostics13040602.
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