Alsahaf Mahdi, Brookes Mark, Shanmuganathan Vijay, Williamson Tom H
Royal Eye Unit, Kingston Hospital NHS Foundation Trust, Galsworthy Rd, Kingston upon Thames, KT2 7QB, United Kingdom.
Department of Ophthalmology, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, United Kingdom.
Am J Ophthalmol Case Rep. 2025 Jun 4;39:102362. doi: 10.1016/j.ajoc.2025.102362. eCollection 2025 Sep.
We present three cases of evolving posterior vitreous detachment (PVD) in which patients experienced black flashes, known as negative dysphotopsia (ND), and were found to have vitreo-papillary adhesion at the optic nerve head.
A 53-year-old female with a history of right rhegmatogenous retinal detachment (RRD) described initial symptoms of black flashes. Seven years later, she developed similar symptoms in the left eye and was diagnosed with PVD. OCT demonstrated vitreo-papillary adhesion.A 47-year-old male with a history of pseudophakic RRD in the left eye 5 years previously presented with black flashes in the right eye on eye movements. He was found to have PVD and RRD after 5 months of these symptoms. OCT revealed separation of the vitreous from the macula with attachment on the optic disc.A 51-year-old male developed ND which were replaced by white flashes after 3 weeks. A week later he was diagnosed with PVD and a retinal tear with OCT evidence of vitreo-papillary traction.
Evolving PVD may present with ND before classical symptoms such as positive dysphotopsia and floaters, particularly in cases with vitreo-papillary adhesion/traction.
我们报告3例正在进展的玻璃体后脱离（PVD）病例，这些患者出现了被称为阴性闪光幻觉（ND）的黑色闪光，并被发现视神经乳头处存在玻璃体 - 视乳头粘连。
一名有右眼孔源性视网膜脱离（RRD）病史的53岁女性描述了最初的黑色闪光症状。7年后，她左眼出现类似症状并被诊断为PVD。光学相干断层扫描（OCT）显示玻璃体 - 视乳头粘连。一名47岁男性，5年前有左眼人工晶状体植入术后RRD病史，在眼球运动时右眼出现黑色闪光。出现这些症状5个月后，他被发现患有PVD和RRD。OCT显示玻璃体与黄斑分离，附着于视盘。一名51岁男性出现ND，3周后变为白色闪光。1周后，他被诊断为PVD和视网膜裂孔，OCT有玻璃体 - 视乳头牵拉的证据。
正在进展的PVD可能在出现如阳性闪光幻觉和飞蚊症等典型症状之前就出现ND，特别是在存在玻璃体 - 视乳头粘连/牵拉的情况下。
