Kongenital optik disk pitine bağlı gelişen seröz maküler dekolman ve tedavi seçenekleri

Kongenital optik disk pitine bağlı gelişen seröz maküler dekolmanların sebeplerinin ve uygulanan tedavilerin etkinliğinin gözden geçirilmesi. Kırkyedi yaşında bayan hasta son bir haftada sol gözünde ani gelişen görme bulanıklığı şikayeti ile başvurdu. Yapılan muayenede sağ göz normal, sol gözde görme keskinliği tashihle 0.7 (+2.0 sph.), optik sinir başının alt temporalinde pit ve bu bölge ile bitişik makülayı da içine alan yaklaşık dört disk çapında seröz dekolman mevcuttu. Bir ay takip sonunda görme 0.2 seviyesine düştü. Hastaya argon laser ile optik disk temporaline iki sıra olacak şekilde fotokoagulasyon yapıldı. 45 gün sonraki kontrolünde görme keskinliği tashihle 0.7 ve dekole alanda gerileme oluştu. Çekilen FFA'de sızdırmanın olmadığı görüldü. Optik disk pitlerine bağlı seröz maküler dekolman gelişebildiği bilinmektedir. Gelişen maküler dekolmanın tedavisinde pek çok yöntem denenmiş ve sıklıkla da optik disk temporaline argon laser fotokoagulasyon (ALF) uygulamaları yayınlanmıştır. Kolay uygulanabilen ve önemli.bir komplikasyona yol açmayan bu yöntemin optik disk piti olan hastalarda dekolman da varsa denenebileceğini düşünmekteyiz.

Anahtar Kelimeler:

Tanı teknikleri, oftalmolojik, Lazer cerrahisi, Optik disk, Retina dekolmanı, Sendrom, Görme keskinliği

Serous macular detachment due to optic disc pit and treatment alternatives

To review the causes of serous macular detachment due to congenital optic disc pit and the efficacy of the treatment. A 47 year-old woman complained of diminution of vision in her left eye in one week. On examination, best corrected visual acuity in the left eye was 0.7 with a refractive correction of +2.0 diopters. Fundus examination revealed the presence of an optic disc pit in the temporal part of the disc. There was an associated serous detachment of the posterior pole about 4 disc-diameter in size. The right eye was evaluated as normal. One month later, visual acuity decreased to 0.2. The -patient was treated with argon laser photocoagulation (ALP) applying two rows of argon green laser burns along the temporal margin of the disc. Six weeks later, the patient stated subjective improvement of vision and visual acuity increased to 0.7. The detached area was flattened. Fluorescein angiography revealed staining of the disc pit but no hyperfluorescence over the posterior pole. Serous macular detachment may occur due to optic disc pits. Many treatment methods were tried in the treatment of serous macular detachment and argon laser photocoagulation applied to the temporal side of the optic disc, is the most common method reported. In conclusion, we also think that since ALP is an easy method which does not cause major important complications, it may be tried in the treatment of patients with serous macular detachments due to optic disc pit.

Keywords:

Diagnostic Techniques, Ophthalmological, Laser Surgery, Optic Disk, Retinal Detachment, Syndrome, Visual Acuity,

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