背景:浆液性SRF的鉴别诊断可能涉及具有广泛不同致病机制的疾病,范围从血管眼病到眼部肿瘤和副肿瘤综合征。最近,范·迪克等人。在三名患者中描述了一种新的实体,他们将其称为无视网膜色素上皮的浆液性黄斑病变(SMARPE)。我们在此描述这种罕见的黄斑疾病的病例,并报告其在多模态成像上的特征性发现。
方法:我们介绍了一个65岁的远视女性,她的左眼有三年的视力(VA)丧失史。先前的光学相干断层扫描(OCT)显示存在浆液性视网膜下液,对玻璃体内注射治疗无反应。在扫频源OCT血管造影扫描中,没有发现视网膜血管丛结构的黄斑改变,也没有脉络膜新生血管形成的证据.左眼的超宽场荧光血管造影显示,早期的高荧光黄斑斑点对应于RPE缺失和晚期荧光素聚集的区域。在超宽视野吲哚菁绿血管造影中,没有脉络膜血管形成的中枢或外周异常。
结论:这个最近描述的实体应被视为持续性浆液性视网膜下液的鉴别诊断。多模态成像有助于将SMARPE与其主要鉴别诊断区分开来,应注意识别并区分其与类似情况,以避免不必要的治疗及其可能的副作用和并发症。
BACKGROUND: The differential diagnosis for serous SRF can involve diseases with widely different pathogenic mechanisms that can range from vascular ocular diseases to ocular tumours and paraneoplastic syndromes. Recently, van Dijk et al. have described in three patients a new entity which they have called serous maculopathy with an absence of retinal pigment epithelium (SMARPE). We hereby describe a
case of this infrequent macular disease and report its characteristic findings on multimodal imaging.
METHODS: We present the
case of a 65-year-old hyperopic woman with a three-year history of visual acuity (VA) loss in her left eye. Prior optical coherence tomography (OCT) had revealed the presence of serous subretinal fluid that had shown no response to treatment with intravitreal injections. On swept source OCT angiography scan, no macular alterations in the retinal vascular plexus structure were noted and there was no evidence of choroidal neovascularization. Ultra-widefield fluorescence angiography of the left eye revealed an early hyperfluorescent macular spot corresponding to the area of absent RPE and late fluorescein pooling. On ultra-widefield indocyanine green angiography there were no central or peripheral abnormalities of choroidal vascularization.
CONCLUSIONS: This recently described entity should be considered as a differential diagnosis in persistent serous subretinal fluid. Multimodal imaging helps differentiate SMARPE from its main differential diagnoses, and care should be taken to identify and differentiate it from similar conditions to avoid unnecessary treatment with its possible side effects and complications.