Successful scleral buckling of late-onset visual decrease in eye with retinal folds.
Successful scleral buckling of late-onset visual decrease in eye with retinal folds.
复制标题
成功进行巩膜扣带治疗患有视网膜皱襞的眼睛迟发性视力下降。
DOI：
10.1007/s10633-016-9559-5
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Azuma N
中科院分区：
文献类型：
--
作者：
Nakayama Y;Katagiri S;Yokoi T;Ui M;Nishina S;Azuma N
目的探讨巩膜屈曲术治疗视网膜径向褶皱（RFs）的疗效。RFs是一种引起晚发性突发性视力下降并伴有中央窝损伤的视网膜褶皱。方法观察性病例报告。术前和术后进行眼科检查，包括测量最佳矫正视力（BCVA）、眼底检查、荧光素血管造影、局灶性黄斑视网膜电图（FM-ERG）和光谱域光学相干断层扫描（OCT）。结果1例患者17岁零3个月时出现鼻上视网膜脱离伴中央凹脱位，右眼BCVA良好，持续BCVA为40/50。17岁11个月时，BCVA突然下降至20/200。眼底检查显示，与先前的报告相比，中央凹与眼底的微脱位和眼底的变窄。电镜图显示几乎消失的反应，OCT图像显示外核和感光层异常。行包皮和桡骨巩膜屈曲。术后4个月，BCVA改善至30/50，与FM-ERG反应的恢复和OCT图像的发现相对应。术后1年零3个月，中央凹复位后，BCVA恢复到35/50。结论在本病例中，同时行巩膜环扎术可使视网膜功能和结构恢复，是治疗因牵引强化而引起的迟发性进行性视网膜病变的有效手术选择。
PurposeTo describe the outcome of scleral buckling to treat radial retinal folds (RFs) that caused a late-onset and sudden visual decrease with impairment of the fovea.MethodsThis is an observational case report. Ophthalmic examinations were performed preoperatively and postoperatively and included measurement of the best-corrected visual acuity (BCVA), fundus examination, fluorescein angiography, focal macular electroretinography (FM-ERG), and spectral-domain optical coherence tomography (OCT).ResultsA patient, whose case was reported previously, had a superonasal retinal detachment with a dislocated fovea and good BCVA in her right eye and a sustained BCVA of 40/50 by age 17 years and 3 months. The BCVA decreased suddenly to 20/200 at age 17 years and 11 months. Fundus examinations showed micro-dislocation of the fovea to the RFs and narrowing of the RFs compared with the previous report. FM-ERG showed an almost extinguished response, and OCT images showed abnormalities of the outer nuclear and photoreceptor layers. Encircling and radial scleral buckling was performed. Four months postoperatively, the BCVA improved to 30/50, which corresponded to the recovery of the FM-ERG response and findings on the OCT images. One year and 3 months postoperatively, the BCVA recovered to 35/50 with repositioning of the fovea.ConclusionsSimultaneous encircling and radial scleral buckling resulted in the recovery of both retinal function and structure in the current case and is a useful surgical option to treat late-onset progressive RFs due to intensification of traction.