先天性视盘小凹合并黄斑劈裂1例

Congenital optic disc pit with macular retinoschisis:A case report

视盘小凹是一种很少见的先天性视神经发育异常。视盘小凹所并发的黄斑病变包括黄斑区视网膜劈裂和视网膜脱离,均是造成患者视力下降的重要原因。关于视盘小凹合并黄斑下积液的来源众说纷纭,主要有3种学说:液化的玻璃体、脑脊液外漏及小凹底部血管的渗漏。本文主要报告中国人民解放军中部战区总医院收治的1名35岁的右眼先天性视盘小凹伴黄斑劈裂的女性患者,手术时行气液交换,观察有液体自小凹处源源不断涌出的现象,将引流液进一步行生化分析,发现与脑脊液成分相似。因此推测视盘小凹合并黄斑下积液来源于脑脊液。

Optic disc pit is a rare congenital anomaly of the optic disc.Optic disc pit maculopathy,including macular retinoschisis and macular detachment,is the important cause of vision loss in patients.The origin of the subretinal fluid at the area of macula in optic disc pit has not been fully understood.Three different hypotheses have been proposed,liquefied vitreous,cerebrospinal fluid leakage from the subarachnoid space and leakage from blood vessels at the optic disc pit.This article reported a 35-year-old female patient presenting with congenital optic disc pit with macular retinoschisis in her right eye admitted to our hospital.During the air-fluid exchange in vitreoretinal surgery,we found a steady stream of fluid gushing from the optic disc pit.Further biochemical analysis showed that its composition was similar to that of cerebrospinal fluid.Therefore,we prefer the hypothesis that the fluid is derived from the cerebrospinal fluid.