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首页> 外文期刊>European journal of ophthalmology >Spontaneous separation in idiopathic vitreomacular traction syndrome associated with contralateral full-thickness macular hole.
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Spontaneous separation in idiopathic vitreomacular traction syndrome associated with contralateral full-thickness macular hole.

机译：与对侧全层黄斑裂孔相关的特发性玻璃体牵引综合征的自发分离。

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PURPOSE: Vitreomacular traction syndrome (VMTS) and full-thickness macular hole are two different well-known entities that on follow-up may be subjected to clinical modifications. Precisely, a spontaneous separation of idiopathic VMTS occurred in three eyes of three patients relieving in addition traction of the posterior hyaloid that had led also to a focal macular retinal pigment epithelial detachment (RPE). An association to a full-thickness macular hole was observed in the contralateral eye of one of the patients. METHODS: This is a retrospective study of three patients evaluated with fluorescein angiography and documented with optical coherence tomography using the Stratus (OCT) model 3000, with scans analysis and protocols analysis, measuring the size and shape of vitreomacular adhesions, macular thickness changes before and after the spontaneous separation of the tractional posterior hyaloid adhesion. In addition, the vitreous was evaluated with contact lens slit lamp biomicroscopy and ultrasound. The associated contralateral macular hole in one of the patients was surgically treated. RESULTS: Two of the three eyes with spontaneous separation of the VMTS recovered 20/25 central visual acuity; the other eye maintained the initial 20/50 visual acuity. The treated macular hole recovered 20/100 corrected visual acuity. CONCLUSIONS: Spontaneous separation of posterior hyaloid is a possible outcome during follow-up of idiopathic VMTS that can be well evaluated and documented with OCT while macular fluorescein angiography may be silent in cases like these presently reported. Central vision recovery can be excellent following the spontaneous separation, which releases anterior-posterior traction including on the retinal pigment epithelium and decreases macular thickness as measured with OCT. Therefore, regarding management, the indication for vitrectomy should be delayed awaiting the spontaneous release of vitreomacular traction in 4 to 6 months. The association between idiopathic VMTS in one eye and full-thickness macular hole in the opposite eye of one patient is an important pathophysiologic consideration.
机译：目的：玻璃体牵引综合征（VMTS）和全层黄斑裂孔是两个不同的知名实体，这些实体在随访时可能会进行临床修饰。准确地说，三位患者的三只眼自发分离出了特发性VMTS，这缓解了后玻璃体的牵引，这也导致了黄斑部视网膜色素上皮脱离（RPE）。在其中一名患者的对侧眼中观察到与全层黄斑裂孔相关。方法：这是一项回顾性研究，对三名接受荧光素血管造影术评估并使用Stratus（OCT）3000型光学相干断层扫描术进行记录的患者进行了扫描分析和方案分析，测量了玻璃体粘连的大小和形状，黄斑厚度的变化以及黄斑厚度的变化。自发分离后牵引性透明样玻璃体粘连。另外，用隐形眼镜裂隙灯生物显微镜和超声评估玻璃体。其中一名患者的相关对侧黄斑裂孔已通过手术治疗。结果：三只眼中有两只VMTS自发分离，中心视力恢复到20/25。另一只眼睛保持最初的20/50视力。经治疗的黄斑裂孔恢复了20/100矫正视力。结论：在特发性VMTS随访期间，可能会自发分离后透明环，可以用OCT进行很好的评估和记录，而在目前报道的此类病例中，黄斑荧光素血管造影可能是沉默的。自发分离后，中心视力恢复可能非常好，这可以释放前后牵引力，包括在视网膜色素上皮上的牵引力，并可以降低OCT所测定的黄斑厚度。因此，在处理方面，应延迟玻璃体切除术的适应症，等待4到6个月内玻璃体牵引的自然释放。一只患者的特发性VMTS与另一只眼睛的另一只眼的全层黄斑裂孔之间的关联是重要的病理生理考虑因素。

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