牵牛花综合征伴裂孔性视网膜脱离的玻璃体手术治疗

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1、牵牛花综合征伴裂孔性视网膜脱离的玻璃体手术治疗【摘要】　　我们报道牵牛花综合征伴裂孔性视网膜脱离经玻璃体手术治疗1例。我们认为：发现裂孔、玻璃体手术解除牵拉力以及长效气体的运用是手术成功的关键。文献也包括对牵牛花综合征伴视网膜脱离的病因及B超对此病诊断意义的讨论。【关键词】牵牛花综合征；视网膜脱离；玻璃体手术　　INTRODUCTION　　Morningglorysyndrome(MGS)isacongenitalanomaly,inedforsimilarityinappearancetothetrumpetshapedmorninggl

2、oryfloalyisunknoostauthorsagreethatisrare.Usuallyunilateral,itischaracterizedbyanexcavatednerveheaddefecttheedgeoftheanomaly.Retinaldetachmenthasbeenreportedin26%38%ofpatientsentinthesecaseshasbeencontroversial.GSisararecongenitalanomalyalitieshavebeenreported.Theseinclu

3、destrabismus,cataract,nystagmus,lenscoloboma,eyelidhemangioma,aniridia,microphthalmos,Duanesretractionsyndromeandretinaldetachment[3,4].Retinaldetachmentisthemostmonocularplicationandisthoughttobedifficulttorepairbecauseretinalbreaksostcases.Severalpathogenicmechanismshav

4、ebeenproposedtoexplainthehighriskofdevelopingretinaldetachmentinpatiententoftheopticnerve[4,5].(2)Abnormalmunicationbetayoccuralloulationsubretinally[2,6].(3)Liquefiedvitreousenteringtheintraretinalspaceattheedgeoftheopticnerve.[4].(4)Leakageoffluidfrombloodvesselsalousop

5、ticdiscorfromtheperipapillarychoroidmayberesponsibleforthesubretinalfluid.Asmallretinalholeintissuelyingintheopticdiscanomalymayprovideafluidpatheeyesyopicandhasaslitlikebreakintheopticdiscanomaly,sothesmallholeatogenousdetachment.ThemaculamayalsobeabnormalinMGSpatients.Y

6、amanaetal[7]correlatedalargerelevatedperipapillaryalmaculalackingareflexandaculailartotheirpatients(Figure1).Thecolorofthemaculaentsintheganglioncells.　　FortheaccuratediagnosisofMGS,exceptforthespecialappearanceoffundus,inescouldshoageologicalfeaturesofMGSfromdifferentaspe

7、cts,otherdiseasessuchasopticdisccoloboma.Forexample,thespecialimageologicalfeaturesofBscanultrasonogram:thevitreouscavityextendedtotheposteriorpoleandopticpapillaprojectedtothebasalpartofmusclecones,thustheposteriorpartofvitreouscavitylookedlikeanupsidedoentcouldalsobese

8、en(Figure3).Bscanultrasonography,inparticularly,isconsideredtobereliableimageologicalmet