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周边盘状变性:一项诊断挑战。

Peripheral Disciform Degeneration: A Diagnostic Challenge.

作者信息

Radotra Anshul, Chawla Mehar, Bandi Sabitha, Manjunatha Nonavinakere

机构信息

Ophthalmology, King's College Hospital National Health Service (NHS) Foundation Trust, London, GBR.

General Practice, Imperial College London, London, GBR.

出版信息

Cureus. 2025 Jul 2;17(7):e87175. doi: 10.7759/cureus.87175. eCollection 2025 Jul.

Abstract

Peripheral disciform degeneration is a rare condition that presents significant diagnostic challenges due to its varied nomenclature and ability to mimic other ocular pathologies, such as choroidal melanoma. An 81-year-old female with longstanding poor vision in her right eye experienced progressive visual deterioration in her only functioning left eye. She underwent urgent evaluation in the eye casualty, followed by further assessment by the medical retina and ocular oncology teams to rule out the possibility of malignancy. Clinical examination and imaging revealed sub-foveal fluid and a hemorrhagic pigment epithelial detachment in the superotemporal quadrant, with angiography demonstrating blocked fluorescence. Based on these findings, a diagnosis of peripheral disciform degeneration was established. Given the presence of sub-foveal involvement, treatment with intravitreal bevacizumab was initiated. A one-month follow-up revealed complete resolution of sub-foveal fluid and an improvement in vision to baseline. This case highlights the importance of increasing awareness of this condition to ensure accurate diagnosis and guide appropriate management, particularly when malignancy is a concern.

摘要

周边盘状变性是一种罕见病症,因其命名多样且能够模仿其他眼部疾病(如脉络膜黑色素瘤)而带来重大诊断挑战。一名81岁女性右眼长期视力不佳,其仅有的功能正常的左眼出现了进行性视力恶化。她在眼科急诊接受了紧急评估,随后医学视网膜和眼科肿瘤团队进行了进一步评估,以排除恶性肿瘤的可能性。临床检查和影像学检查发现黄斑下积液以及颞上象限的出血性色素上皮脱离,血管造影显示荧光阻滞。基于这些发现,确诊为周边盘状变性。鉴于黄斑下受累,开始玻璃体腔注射贝伐单抗治疗。一个月的随访显示黄斑下积液完全消退,视力恢复到基线水平。该病例凸显了提高对这种病症认识的重要性,以确保准确诊断并指导适当的治疗,尤其是在存在恶性肿瘤疑虑的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7458/12316191/d475e1bd8a4f/cureus-0017-00000087175-i01.jpg

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