双眼急性区域性隐匿性外层视网膜病变1例

Bilateral acute regional occult outer retinopathy:a case report

患者女性,63岁,因“双眼闪光感伴视力下降1年”就诊。视野检查见双眼中心30°视野部分缺损,双眼扫描激光眼底照相检查发现双眼视网膜整个后极部可见大范围萎缩灶,相干光层析成像术检查可见双眼黄斑区视网膜萎缩变薄,其中与视野异常相对应的区域光感受器内节和外节层萎缩消失,荧光素眼底血管造影术检查显示视网膜动脉变细,造影早期后极部视网膜大面积窗样缺损,透见脉络膜大血管背景荧光,晚期呈片状荧光着染,其周呈环状强荧光区。电生理检查显示双眼P 100振幅明显下降。诊断双眼急性区域性隐匿性外层视网膜病变。

A 63-year-old female patient presented with"flashes of light in both eyes accompanied by decreased visual acuity for one year."Visual field examination revealed partial defects in the central 30°of the visual field in both eyes.Scanning laser ophthalmoscopy showed extensive atrophic lesions across the entire posterior pole of the retina in both eyes.Optical coherence tomography revealed atrophy and thinning of the retina in the macular regions,with significant atrophy of the photoreceptor inner segment and outer segment layer in the areas corresponding to the visual field defects.Fluorescein fundus angiography demonstrated thinning of the retinal arterioles.Early-phase imaging showed large window-like defects in the posterior retina with background fluorescence from choroidal macrovessels.In the late phase,patchy fluorescence staining with a circumferential hyperfluorescent area was observed.Pattern visual evoked potential and pattern electroretinography tests revealed a significant decrease in the P100 amplitude in both eyes.The patient was diagnosed with acute regional occult outer layer retinopathy in both eyes.