Macular microholes: pathogenesis and natural history
Macular microholes: pathogenesis and natural history
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DOI：
10.1136/bjo.2004.052084
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发表时间：
2005-02-01
影响因子：
4.1
通讯作者：
Gregor, ZJ
中科院分区：
文献类型：
--
作者：
Zambarakji, HJ;Schlottmann, P;Gregor, ZJ
目的：目的：研究黄斑区微小孔的自然病程，评价光学相干断层扫描（OCT）和视网膜厚度分析仪（RTA）对黄斑区微小孔的诊断价值。进行了血管造影（FA）、RTA和OCT。主要结果指标为视力（VA）、OCT和RTA微孔特征。结果：12例13眼患者平均年龄50岁，平均屈光不正为-0.93屈光度，术后随访6个月。临床表现为中心暗点14眼，视物变形8眼。所有患者的矫正视力范围为20/16至20/125，24只眼中有20只（83%）的视力大于或等于20/40。22例患者中有16例（72%）的症状保持稳定或改善。OCT 2结果正常，但OCT 3显示15/18只眼（83%）的外层视网膜异常和/或视网膜色素上皮（RPE）缺损。RTA地形图显示12只眼睛中有2只眼睛的微孔部位存在缺陷。结论：尽管生物显微镜检查提示内中央凹缺陷，但OCT 3扫描显示外视网膜和/或RPE的局部异常，无法使用OCT 2解决。黄斑微孔具有良好的长期预后，视力稳定。双边参与并不常见。
Aims: To study the natural history and evaluate optical coherence tomography (OCT) and the retinal thickness analyser (RTA) in patients with macular microholes.Methods: The medical records of 22 patients with a well demarcated red intraretinal foveal or juxtafoveal defect were reviewed. Fluorescein angiography ( FA), RTA, and OCT were performed. The main outcome measures were visual acuity (VA), and OCT and RTA characteristics of microholes. Long term follow up was available in 13 eyes of 12 patients.Results: The patients had a mean age of 50 years and a mean refractive error of -0.93 dioptres. The presenting symptom was a central scotoma in 14 eyes and metamorphopsia in eight eyes. All patients had a corrected VA ranging from 20/16 to 20/125, with 20 out of 24 eyes (83%) having a VA greater than or equal to20/40. Symptoms remained stable or improved in 16 out of 22 patients (72%). OCT 2 findings were normal but an abnormality of the outer retina and/or a defect of the retinal pigment epithelium (RPE) were demonstrated on OCT 3 in 15 of 18 eyes ( 83%). The RTA topographic map demonstrated a defect at the site of the microhole in two out of 12 eyes.Conclusion: Although biomicroscopic examination suggested an inner foveal defect, the OCT 3 scans demonstrated a localised abnormality of the outer retina and/or RPE which could not be resolved using OCT 2. Macular microholes have a favourable long term prognosis with stable VA. Bilateral involvement is uncommon.