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NR 7-9/2006
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Samoistne przedarcie
warstwy barwnikowej siatkówki (RPE) w przebiegu wysokiej
krótkowzroczności
Spontaneous RPE tear in high
myopia
Piotr Fryczkowski, Anna Jędruch, Maria
Kmera-Muszyńska
Z Katedry i Kliniki Okulistyki II Wydziału Lekarskiego Akademii
Medycznej w Warszawie
Z Samodzielnego Publicznego Klinicznego Szpitala Okulistycznego
w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik |
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| Summary: |
Purpose: The aim of
this study is to present the case of a spontaneous
retinal pigment epithelial tear in high myopia.
Material and methods: A 56 years old woman with
high myopia (refractive error -10.0D) in both eyes and
amblyopia in right eye since childhood, complained of a
decrease in left eye vision for one and a half month.
Full ophthalmic examination, fundus photography,
ultrasound examination and indocyanine green angiography
were performed.
Results: At first visit BCVA was 5/25 in her left
eye. A subretinal hemorrhage accompanied by retinal
pigment epithelial tear inferotemporal to the fovea was
found in ocular examination. B-scan ultrasound did not
revealed any traction at the fovea. 3 months later BCVA
was 5/16 OS. The area of the atrophy of RPE – Bruch’s
membrane – choriocapillaris complex expanded and
hyperpigmentation occured above the RPE tear. 3 months
later BCVA was 2/50 OS, we observed a dark brown pigment
spot surrounded with a subretinal hemorrhage somewhat
above the RPE tear. Indocyanine green angiography
demonstrated an initial choroidal neovascularization at
superotemporal edge of hypertrophic pigment epithelium (Fuch’s
spot).
Conclusions: A spontaneous RPE tear might be the
beginning of Fuchs’ spot. A mechanical stress associated
with eye movement is transmitted through the thin sclera
and Bruch’s membrane onto RPE and may cause a tear in
its most vulnerable place i.e. at the margin of
posterior staphyloma. |
| Słowa kluczowe: |
przedarcie warstwy
barwnikowej siatkówki, krótkowzroczność wysoka, plama
Fuchsa, neowaskularyzacja podsiatkówkowa. |
| Key words: |
retinal pigment epithelial
tear, high myopia, Fuchs’ spot, choroidal
neovascularization, RPE. |
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