背景:已经有一些关于黄斑孔自发闭合和重新打开的报道,然而,在大多数情况下,在玻璃体切除术后的眼睛中观察到。这里,我们报告了1例发生多次自发消失和即将发生的黄斑裂孔复发(第1B期黄斑裂孔),既往无手术史.
方法:一名76岁的日本男子主诉右眼视力下降。在初步检查中,他的右眼和左眼的视力分别为0.4和0.01。他以前被诊断为左眼患有不明原因的黄斑变性。光学相干断层扫描成像证实了他的右眼玻璃体黄斑牵引和即将出现的黄斑裂孔。经过1周的随访,发现玻璃体后脱离,即将出现的黄斑裂孔似乎得到了解决。两个月后,即将出现的黄斑裂孔完全消失,视力提高至0.9.六个月后,他再次注意到右眼视力下降。检查显示,他的视力下降到0.4,并且有即将出现的黄斑裂孔的复发。光学相干断层扫描检查没有明确的玻璃体牵引发现,and,一个月后,再次观察到自发消失,他的视力提高到0.7。
结论:在这种情况下,初始发作和复发都涉及即将出现的黄斑裂孔,然而,每次检查的光学相干断层扫描结果不同.这些发现表明,在这种情况下,除玻璃体牵引以外的其他原因是造成即将来临的黄斑裂孔的自发消失和复发的原因。
BACKGROUND: There have been several
reports of spontaneous closure and reopening of a macular hole, however, in most of those cases, it was observed in eyes post vitrectomy. Here, we report a
case of multiple episodes of spontaneous disappearance and recurrence of impending macular hole (stage 1B macular hole) with no history of previous surgery.
METHODS: A 76-year-old Japanese man presented with a primary complaint of reduced visual acuity in his right eye. On initial examination, the visual acuity in his right and left eye was 0.4 and 0.01, respectively. He had previously been diagnosed as having macular degeneration of unknown origin in his left eye. Optical coherence tomography imaging confirmed vitreomacular traction and impending macular hole in his right eye. After a 1-week follow-up period, posterior vitreous detachment was detected, and the impending macular hole appeared to be resolved. Two months later, the impending macular hole had completely disappeared and his visual acuity had improved to 0.9. Six months later, he again noticed decreased vision in his right eye. An examination revealed that his visual acuity had dropped to 0.4, and there was a recurrence of impending macular hole. An optical coherence tomography examination showed no definitive findings of vitreous traction, and, 1 month later, spontaneous disappearance was observed again and his visual acuity improved to 0.7.
CONCLUSIONS: In this
case, both the initial onset and the recurrence involved impending macular hole, however, the optical coherence tomography findings differed at each examination. These findings suggest that some causes other than vitreous traction were responsible for both the spontaneous disappearance and recurrence of the impending macular hole in this present
case.