目的:介绍一例星状非遗传性特发性黄斑视网膜裂孔(SNIFR)消退与玻璃体黄斑粘连(VMA)释放相关的病例,并提出SNIFR与玻璃体黄斑相互作用之间的潜在关联。
方法:对一名67岁女性患者进行诊断,并在第3、6、16和22个月的就诊和随后的就诊时用光谱域光学相干断层扫描(SD-OCT)扫描进行ODSNIFR随访。在随访的前6个月中,在SD-OCT上VMA和黄斑视网膜裂孔保持不变。在16个月的随访中,SD-OCT显示VMA释放和黄斑裂开的重要改善。在22个月的随访中,在没有任何辅助治疗的情况下,SNIFR腔在与黄斑区的后部玻璃样分离的情况下完全解决。在这种情况下,除了VMA释放外,作者无法确定任何其他可能的原因来证明SNIFR的解决。患者在初次就诊后3个月除超声乳化外没有接受任何OD治疗。
结论:本案例说明了SD-OCT扫描在SNIFR分辨率和VMA释放之间可能存在关联,突出显示内部限制膜上的后玻璃体的潜在牵引成分,以及随之而来的神经胶质细胞随着分裂形成而伸展。
OBJECTIVE: To present a case of stellate nonhereditary idiopathic foveomacular retinoschisis (SNIFR) resolution associated with vitreomacular adherence (VMA) release and propose a potential contributing association between SNIFR and vitreomacular interactions.
METHODS: A 67-year-old female patient was diagnosed and followed for SNIFR in OD with spectral-domain optical coherence tomography (SD-OCT) scans at presentation and subsequent visits at 3, 6, 16 and 22 months. VMA and foveomacular retinoschisis remained unchanged on SD-OCT during the first 6 months of the follow-up. At 16-month follow-up visit, SD-OCT revealed VMA release and an important improvement of the macular schisis. At 22 months of follow-up, SNIFR cavities completely resolved in the presence of posterior hyaloid separation from the macular area without any adjunct treatment. The authors could not identify any other possible cause to justify the resolution of SNIFR other than VMA release in this case. Patient did not undergo any treatment for OD other than phacoemulsification 3 months after initial visit.
CONCLUSIONS: The present case illustrates with SD-OCT scans a possible association between SNIFR resolution and VMA release, highlighting a potential tractional component of the posterior vitreous on the internal limiting membrane and consequent glial cells stretching with schisis formation.