Management of full-thickness macular holes in patients with retinitis pigmentosa – a case series of 5 patients operated with pars plana vitrectomy
摘要
Retinitis pigmentosa is a progressive retinal dystrophy with a complex genetic background that can be part of a systemic syndrome or is restricted to the eye organ. Apart from retinal changes, this entity is linked to subcapsular cataract and epiretinal membrane formation. Surgical interventions can help to partially restore the visual acuity, but need to be considered carefully with assessment of the predicted outcomes.
ObservationsFive patients diagnosed with retinitis pigmentosa, including one with Usher syndrome, were operated using a similar core technique of pars plana vitrectomy, with some modifications including inner limiting membrane peeling with flap inversion and gas tamponade. Optical coherence tomography pre- and postoperatively were made along with BVCA measurements, showing improvement correlated with early intervention and younger age of the patients.
Conclusions and importanceFull thickness macular holes rarely occur in patients with retinitis pigmentosa, therefore knowledge on the improvement of vision after vitreoretinal surgery in this cases remains uncertain and limited. Diagnostic modalities such as autofluorescence imaging or electroretinography can be useful to predict possible benefits of surgical treatment. In cases of full thickness macular holes of RP patients, it seems that restoring foveal integrity is relevant, since the fovea gets damaged last in the dystrophic pathology.