PDF(Pubmed)
Abstract：
The purpose of this report was to present a case of a refractory full-thickness macular hole (FTMH) complicated with recurrent retinal detachment (RD) previously treated with an autologous platelet-rich plasma (aPRP) plug. A 65-year-old male patient presented to our department with a FTMH, RD, and a giant retinal break. Preoperative best corrected visual acuity (BCVA) was 1.40 logMAR (20/500). A 25-G pars plana vitrectomy (PPV) was performed, with peripheral retinal-breaks laser barrage, peeling of the internal limiting membrane, and silicon oil injection. One month later, spectral domain optical coherence tomography (SD-OCT) showed the persistence of the FTMH with a diameter of 712 μm. Therefore, the patient underwent silicon oil removal and aPRP injection with good anatomical outcome and improvement of BCVA to 0.6 log-MAR (20/80). Two months later a recurrence of macula-off RD was detected, but SD-OCT showed that the aPRP plug was still in place and kept the two margins of the macular hole together. The patient underwent a further PPV with silicon oil injection and subsequent silicon oil removal with no postoperative complications. Two months later, the retina remained attached, SD-OCT confirmed FTMH closure and BCVA was 0.52 logMAR (20/63). In conclusion, this case report aims to underline the remarkable efficacy of aPRP in promoting FTMH closure, which was maintained despite subsequent recurrence of macula-off RD.
摘要：
本报告的目的是介绍一例难治性全厚度黄斑裂孔（FTMH）并发复发性视网膜脱离（RD）的病例，该病例先前使用自体富血小板血浆（aPRP）塞治疗。一名65岁的男性患者带着FTMH到我们部门就诊，RD,和巨大的视网膜破裂。术前最好矫正视力(BCVA)为1.40logMAR(20/500)。进行了25-G平面玻璃体切除术（PPV），周边视网膜破裂激光弹幕，内部限制膜的剥离，和硅油注射。一个月后,谱域光学相干断层扫描（SD-OCT）显示了直径为712μm的FTMH的持久性。因此,患者接受了硅油去除和aPRP注射,解剖结果良好,BCVA提高至0.6log-MAR(20/80).两个月后，发现黄斑脱离RD复发，但SD-OCT显示aPRP堵塞物仍在原位,并将黄斑孔的两个边缘保持在一起.患者接受了进一步的PPV，并注射了硅油，随后去除硅油，无术后并发症。两个月后,视网膜仍然附着，SD-OCT证实FTMH闭合，BCVA为0.52logMAR（20/63）。总之,本病例报告旨在强调aPRP在促进FTMH关闭方面的显着功效，尽管随后黄斑脱离RD复发，但仍得以维持。
