放出视网膜下液,气液交换。鼻下方囊肿穿刺放液,双侧囊肿周边直视下巩膜外冷凝。术后全身及局部予激素抗炎治疗,1个月后左眼BCVA0.3,左眼压:20 mmHg,视盘界清色淡红,视网膜复位良好,双囊肿均消失,颞侧及黄斑区可见少量陈旧机化灶,中心凹反射(—)(见图4和5)。
图1 B超示位于玻璃体腔的颞下方的视网膜囊肿(白箭头)Fig 1 B-mode ultrasonography: a retinal cyst located inferior temporal part of the vitreous cavity (white arrow)
图2 位于玻璃体腔鼻下方视网膜囊肿B超声像,囊肿内可见点状均匀一致弱回声(白箭头)Fig 2 The B-ultrasound image of the retinal cyst located inferior temporal part of the vitreous cavity, and the dot-like uniform weak echo can be seen in the cyst (white arrow)
图3 正下方B超声像图可同时见视网膜双囊肿(白箭头)Fig 3 The double cysts of the retina (white arrow) can be seen at the same time in the B-ultrasound image directly below
图4 术后1个月B超声像见视网膜已复位,双囊肿均消失Fig 4 One month after operation, the retina was reattached and the double cysts disappeared
A:术前;B:术后图5 左眼术前及术后眼底彩色照片Fig 5 Fundus photos of left eye before and after operation
2 讨论
视网膜囊肿是一种较少见的眼底疾病,其病理改变是视网膜的内核层与外核层之间劈裂而形成囊腔,即视网膜的层间分离[1]。该囊肿并无上皮衬里,属于假性囊肿,好发于视网膜颞下方[2]。视网膜囊肿分为先天性和获得性两种,合并视网膜脱离的属于获得性,多由长期陈旧视网膜脱离或变性