Выяснение причин отслойки нейроэпителия с целью постановки корректного диагноза у пациентов с патологией макулярной области

Abstract

Purpose. To assess the difficulties of finding out true cause of detachment of neuroepithelium in patients with various retinal pathologies. Material and methods. 3 patients (3 eyes) aged 51 to 59 years with complaints of sensation of a “spot» in front of the eye, decreased vision and metamorphopsia. The best corrected visual acuity ranged from 0.4 to 0.5. Rounded local prominating lesion – zones of local detachment of neuroepithelium, zones of local atrophy or defects in retinal pigment epithelium (RPE) were determined in all 3 eyes in the posterior pole of the eye. Results. According to results of optical coherence tomography (OCT), all 3 eyes had local serous detachment of neuroepithelium from 250 to 270 µm, local inclusions characterized by hyperreflective and heterogeneous RPE layer, episodically located in its layers hyperreflective areas with point breach in the Bruch membrane (“hard» drusen). Irregular RPE elevations (“wavy pattern») with its local fibrovascular detachment were determined. According to the results of OCT angiography, hyperreflective zones of the presence of a neovascular network in the layer of choriocapillaries under the areas of fibrovascular detachment of RPE, coinciding with zones of hyperautofluorescence, were revealed in all 3 eyes. In paired eyes of all 3 patients, “hard» retinal drusen in the macular zone were detected. Conclusions. 1. All 3 eyes were diagnosed with the wet form agerelated macular degeneration due to: their belonging to the older age group, low corrected visual acuity, the presence of complaints of metamorphopsia, irregular elevation and local fibrovascular detachment of RPE, the presence of local hyperautofluorescence, and presence of drusen on the double eye. 2. The use of OCT angiography makes it possible to differentiate between central serous chorioretinopathy and age-related macular degeneration by detecting choroidal neovascularization. Keywords: central serous chorioretinopathy, wet AMD, detachment of neuroepithelium