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近视性牵引性黄斑病变中的多个黄斑旁视网膜脱离

Multiple parafoveal retinal detachment in myopic tractional maculopathy.

作者信息

Yeh Tsai-Chu, Chen Shih-Jen

机构信息

Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.

School of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan.

出版信息

Taiwan J Ophthalmol. 2024 Nov 26;14(4):624-628. doi: 10.4103/tjo.TJO-D-24-00077. eCollection 2024 Oct-Dec.

Abstract

This study investigates the occurrence of multiple parafoveal retinal detachments (RDs) in myopic traction maculopathy (MTM), emphasizing the atypical extrafoveal involvement compared to central foveal detachment commonly observed. Patient 1, a 46-year-old male, exhibited MTM with retinoschisis and four small subretinal fluid (SRF) pockets inferior to the fovea, accompanied by a hyperautofluorescent vitelliform deposit. Patient 2, a 43-year-old male, reported ring-shaped dim vision in the left eye, displaying MTM with six stable SRF pockets surrounding the fovea. These SRF pockets maintained a stable size ranging from 173 to 1140 um in diameter over the course of a 5-year follow-up period. Interestingly, fluorescein and indocyanine angiography showed no leakage or hyperpermeability in both cases. The study highlights the necessity for a comprehensive exploration of extrafoveal RDs in MTM, challenging conventional expectations. The mechanism of these persistent extrafoveal detachments associated with myopic schisis was unknown. The findings prompt further research to unravel the intricate mechanisms of this rarely reported phenomenon, emphasizing the importance of expanding our understanding of extrafoveal manifestations in eyes with MTM.

摘要

本研究调查了近视性牵引性黄斑病变(MTM)中多个黄斑旁视网膜脱离(RD)的发生情况,强调了与常见的中央黄斑脱离相比,其非典型的黄斑外累及情况。患者1为一名46岁男性,患有伴有视网膜劈裂的MTM,在黄斑下方有四个小的视网膜下液(SRF)腔隙,并伴有高自发荧光的卵黄样沉积物。患者2为一名43岁男性,左眼有环形视力模糊,患有MTM,在黄斑周围有六个稳定的SRF腔隙。在5年的随访期间,这些SRF腔隙的大小保持稳定,直径范围为173至1140微米。有趣的是,荧光素和吲哚菁绿血管造影显示这两个病例均无渗漏或高通透性。该研究强调了全面探索MTM中黄斑外RD的必要性,这对传统预期提出了挑战。与近视性劈裂相关的这些持续性黄斑外脱离的机制尚不清楚。这些发现促使进一步研究以阐明这种罕见报道现象的复杂机制,强调了扩大我们对MTM患者黄斑外表现理解的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4f9/11717334/a93f92cbf4b2/TJO-14-624-g001.jpg

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