背景:双视盘凹陷黄斑病变是一种罕见的疾病。由于过度渗漏和慢性黄斑病变,可能难以管理。
目的:描述一例双视盘小窝伴黄斑病变的手术治疗。
结论:一名42岁男性,左眼有双视盘凹陷伴黄斑脱离。最佳矫正视力(BCVA)为20/60,N12。术前OCT显示存在两个椎间盘凹陷。黄斑区具有大的视网膜裂孔和视网膜下液(SRF),中央凹厚度为879微米,并且失去了椭圆体区。还注意到从椎间盘的时间方面到黄斑下区域的浅层交流。在观察的选择中,激光光凝,和手术,患者选择了手术治疗.
方法:进行标准-3端口23号平面玻璃体切除术。用亮蓝色染色ILM后,在镊子和Finesse循环的帮助下进行ILM剥离。将ILM瓣倒置以覆盖视神经盘凹坑,并用一滴纤维蛋白胶密封。接下来,20%SF6气体用于填塞。评估手术前后的参数,如视力和OCT。
■6周后,左眼BCVA为20/40,OCT显示SRF减少,视网膜内裂减少,中央凹厚度为546微米.随访3个月时,左眼视力改善至20/30,视网膜裂孔和中央凹厚度进一步减少482微米。
结论:在这个有趣的案例中,我们展示了一种独特的方法,通过玻璃体切除术和在椎间盘凹陷上用纤维蛋白胶倒置的ILM皮瓣手术密封缺损。尽管密封,黄斑病变解决缓慢。
■https://youtu。是/s9nY5UPe1s4。
BACKGROUND: Double optic disc pit maculopathy is a rare entity. It can be difficult to manage because of excessive leakage and chronic maculopathy.
OBJECTIVE: To describe surgical management in a
case of double optic disc pits with maculopathy.
CONCLUSIONS: A 42-year-old male presented with double optic disc pits with macular detachment in the left eye. The best-corrected visual acuity (BCVA) was 20/60, N12. Preoperative OCT showed the presence of two disc pits. The macular region had large retinoschisis and subretinal fluid (SRF) with a central foveal thickness of 879 microns and loss of the ellipsoid zone. A shallow communication from the temporal aspect of the disc to the submacular area was also noted. Among the options of observation, laser photocoagulation, and surgery, the patient opted for surgical management.
METHODS: A standard-3 port 23-gauge pars plana vitrectomy was done. After staining the ILM with brilliant blue, ILM peeling was done with the help of forceps and Finesse loop. ILM flaps were inverted over to cover the optic disc pits and sealed with a drop of fibrin glue. Next, 20% SF6 gas was used for tamponade. Pre- and post-surgery parameters such as visual acuity and OCT were evaluated.
UNASSIGNED: After 6 weeks, left eye BCVA was 20/40 with OCT showing reduced SRF and reduced intraretinal schisis with a foveal thickness of 546 microns. At 3 months of follow-up, the vision in the left eye had improved to 20/30 with further reduction in the retinoschisis and foveal thickness of 482 microns.
CONCLUSIONS: In this interesting
case, we demonstrate a unique way of sealing the defect surgically by vitrectomy and inverted ILM flap with fibrin glue over the disc pits. Despite sealing the maculopathy is slow to resolve.
UNASSIGNED: https://youtu.be/s9nY5UPe1s4.