玻璃體黃斑部牽扯症引發之黃斑部網膜剝離－病例報告

Macular Detachment in Vitreomacular Traction Syndrome-One Case Report

陳偉勵(Wei-Li Chen) ； 楊中美(Chung-May Yang) ； 陳慕師(Muh-Shy Chen)

《中華民國眼科醫學會雜誌》 37卷3期 (1998/09) Pp. 285-290

https://doi.org/10.30048/ACTASOS.199809.0009

摘要

玻璃體黃斑部牽扯症(Vitreomacular traction syndrome)乃“玻璃體後部的未完全剝離”(incomplete posterior vitreous detachment)拉扯黃斑部所引起，其為引起老年人口視力模糊或視覺影像扭曲之重要成因之一，極少數的病患甚至會出現強大的牽扯力量，進而引發牽扯性視網膜剝離(tractional retinal detachment)。本篇研究即報告一名曾診斷為右眼“網膜前增生膜”併“偽黃斑部破孔”的74歲病患，主訴為右眼視力模糊數個月，而病患眼底可見未完全剝離的縮凝玻璃體接連至黃斑部，並且引發黃斑部牽扯性網膜剝離。本病患在接受玻璃體切除術後，雖網膜剝離消失，網膜復位情形良好；但術後發現黃斑部破孔，故術後視力不佳。
黃斑部牽扯性網膜剝離為玻璃體黃斑部牽扯症最嚴重的一種表現，雖然可嚐試用玻璃體切除街治療此罕見的嚴重病例，但因黃斑部往往已存在病變，故其治療成效令人不盡滿意。

並列摘要

Vitreomacular traction syndrome, characterized by macular traction induced by the partially detached posterior hyloid, is an important cause of decreased and distorted central vision in old age group. Rarely, the force exerted on the posterior pole may be strong enough to cause macular detachment. We presented a 73-year-old male who complained of decreased vision in his right eye for 6 months. He was previously diagnosed to have epiretinal membrane with pseudo-hole formation in the right eye. Biomicroscopically, condensed and partially detached vitreous adhered to the macular area with macular detachment was noted.
Pars plana vitrectomy was performed to relieve the traction. Postoperatively macular hole developed, and the visual acuity remained the same. Macular detachment is the most severe form of vitremacular traction syndrome. Although operation can be done to flatten the macular, the prognosis is poor.

並列關鍵字

Vitreomacular traction syndrome ； traction detachment ； retinal detachment ； posterior vitreous detachment