Hirai Asaki, Kikuchi Yota, Ohara Yuki, Ohta Toshihiko, Nakao Shintaro
Department of Ophthalmology of Juntendo University Shizuoka Hospital, Tokyo, Japan.
Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan.
Case Rep Ophthalmol. 2025 Mar 3;16(1):239-245. doi: 10.1159/000545011. eCollection 2025 Jan-Dec.
We aimed to report macular morphological changes observed on optical coherence tomography (OCT) in a child with familial exudative vitreoretinopathy (FEVR), experiencing macular traction caused by fibrovascular tissue (FT), who underwent vitrectomy.
A 7-year-old girl presented with the chief complaint of decreased visual acuity in the left eye during a school examination. Fundus examination revealed retinal folds with FT extending from the peripheral retina to the posterior pole of the left eye. Despite interventions such as retinal photocoagulation and encircling buckling aimed at reducing the traction on the macula, OCT revealed persistent deep retinal folds and a thickened outer nuclear layer (ONL), indicating gradually increasing macular traction, which contributed to vision loss. A subsequent vitrectomy alleviated the macular traction, enhanced the retinal morphology, and reduced ONL thickening regardless of persistent ectopic inner foveal layers.
Macular morphological changes before and after vitrectomy in a pediatric case of FEVR can be observed using OCT. Vitrectomy with FT removal may be effective in partially improving macular morphology in FEVR with macular traction.
我们旨在报告一名患有家族性渗出性玻璃体视网膜病变(FEVR)的儿童在接受玻璃体切割术时,通过光学相干断层扫描(OCT)观察到的黄斑形态变化。该患儿因纤维血管组织(FT)导致黄斑牵拉。
一名7岁女孩在学校检查时以左眼视力下降为主诉就诊。眼底检查发现视网膜褶皱,FT从周边视网膜延伸至左眼后极。尽管采取了视网膜光凝和环扎等干预措施以减轻对黄斑的牵拉,但OCT显示视网膜深层褶皱持续存在且外核层(ONL)增厚,表明黄斑牵拉逐渐加重,导致视力丧失。随后的玻璃体切割术缓解了黄斑牵拉,改善了视网膜形态,且无论持续性异位中心凹内层如何,ONL增厚均减轻。
使用OCT可观察到FEVR小儿病例玻璃体切割术前后的黄斑形态变化。切除FT的玻璃体切割术可能对部分改善伴有黄斑牵拉的FEVR的黄斑形态有效。