Unusual Vitreomacular Traction Associated with Retinitis Pigmentosa: A Case Report

以玻璃體切除手術治療因視網膜色素變性上皮失養症合併玻璃體黃斑牽引症的少見病例

張汎屏(Fan-Ping Chang) ； 許淑娟(Shwu-Jiuan Sheu)

《中華民國眼科醫學會雜誌》 46卷4期 (2007/12) Pp. 433-438

https://doi.org/10.30048/ACTASOS.200712.0007

摘要

目的：報告一例因視網膜色素上皮失養症變性合併玻璃體黃斑牽引症少見病例。
方法：病例報告。
結果：一位50歲男性因左眼視物變形而求診病人本身四年前就被診斷有視網膜色素上皮失養症且合併周邊視野缺損，經光學同調斷層掃描(OCT)證實在左眼有後側玻璃體剝離所造成黃斑部牽引症。在一個月後進行玻璃體切除手術，術後黃斑部牽引及黃斑部水腫均有明顯改善，並在五個月後因併發白內障進行水晶體乳化手術及後房人工水晶體植入手術，術後視力維持在0.3。
結論：玻璃體黃斑牽引症可發生在視網膜色素上皮失養症的病人，而光學同調斷層掃描(OCT)用於評估玻璃體黃斑牽引症候群術前及術後的黃斑部狀況是相當好的診斷工具。對於此類病人，玻璃體切除手術可以提供解剖學上的改善。

並列摘要

Purpose: To report an unusual case of retinitis pigmentosa with vitreomacular traction
Method: A case report
Results: A 50-year-old male patient presented with metamorphopsia in the left eye. He was diagnosed as retinitis pigmentosa 4 years ago and lost peripheral visual field. Optical coherence tomography (OCT) showed posterior vitreous detachment (PVD) except thin attachments to the nasal macula and optic nerve, resulting in macular traction of the left eye. We performed a pars plana vitrectomy of the left eye 1 month after diagnosis. The vitreomacular traction resolved and macula edema disappeared after surgery. Five months later, he received phacoemulsification and posterior chamber intraocular lens implantation due to progressive complicated cataract. The best-corrected visual acuity was 6/20 in the left eye at the last follow-up.
Conclusion: Vitreomacular traction can occur in retinitis pigmentosa patients. OCT is a good method for evaluating the macula both before and after vitrectomy. In this case, vitrectomy provides anatomical improvement.

並列關鍵字

Optical coherence tomography OCT ； retinitis pigmentosa ； vitrectomy ； vitreomacular traction