PDF(Pubmed)
Abstract：
Vitreomacular Interface pathology and its surgical treatment is an ever-evolving field in vitreoretinal surgery. Various treatments have been proposed for macular holes associated with vitreomacular traction including ocriplasmin injection, gas injection, and pars plana vitrectomy with posterior hyaloid face stripping with or without internal limiting membrane peeling. The time of intervention in patients with vitreomacular traction syndrome is also a point of contention among researchers. Here we present a case of an 83-year-old male patient who presented to the outpatient department with a history of grossly decreased visual acuity of counting fingers in the right eye. An altered foveal reflex was seen in an otherwise unremarkable ocular examination. The left eye revealed no pertinent findings. The patient was diagnosed with vitreomacular traction syndrome on spectral domain optical coherence tomography. There was an associated grade 1b macular hole according to the International Vitreomacular Traction Study classification. As the roof of the macular hole was intact, we decided to proceed with pars plana vitrectomy and careful stripping of the posterior hyaloid face. However, this resulted in a full-thickness macular hole and no change in visual acuity. A second surgery comprising internal limiting membrane peel using brilliant blue dye with perfluoropropane (C3F8) gas tamponade was done. Follow-up after six weeks showed a visual acuity improvement to 20/120 and restoration of foveal configuration. To the best of our knowledge, such a clinical case has not been reported in locally published literature.
摘要：
玻璃体视网膜界面病理学及其手术治疗是玻璃体视网膜手术中不断发展的领域。已经提出了各种治疗方法，用于与玻璃体黄斑牵引相关的黄斑裂孔，包括ocriplasmin注射，注气,和平坦部玻璃体切除术，后透明面剥离，有或没有内界膜剥离。玻璃体黄斑牵引综合征患者的干预时间也是研究人员的争论点。在这里，我们介绍了一例83岁的男性患者，该患者就诊于门诊部，其右眼数指的视敏度严重下降。在其他不明显的眼部检查中发现了中央凹反射的改变。左眼没有发现相关的发现。该患者在光谱域光学相干断层扫描上被诊断为玻璃体黄斑牵引综合征。根据国际玻璃体牵引研究分类，存在相关的1b级黄斑裂孔。由于黄斑孔的顶部完好无损，我们决定继续进行平坦部玻璃体切除术，并小心地剥除玻璃后面。然而,这导致全厚度黄斑裂孔，视力没有变化。进行了第二次手术，包括使用亮蓝染料和全氟丙烷（C3F8）气体填塞的内界膜剥离。六周后的随访显示视力改善至20/120，并恢复了中央凹构型。据我们所知,此类临床病例尚未在当地发表的文献中报道。
