RESUMO
The separation of outer retinal photoreceptors in patients with toxoplasmosis chorioretinitis was first named bacillary layer detachment (BALAD), which was manifested as a split at the level of the photoreceptor inner segment myoid creating a distinctive intraretinal cavity in optical coherence tomography.Subsequently BALAD has been reported by many researchers in different diseases.In the outer retina, the myoid is a relatively weak structure in photoreceptor inner segment.When the outward force that promotes the attachment of the photoreceptor outer segment to the retinal pigment epithelium exceeds the tensile strength of the photoreceptor inner segment myoid, the myoid zone splits and BALAD occurs.BALAD has its unique multimodal imaging characteristics, and the identification of it can provide a new idea for the diagnosis, detection and treatment of ocular diseases.This paper reviewed the development of BALAD nomenclature, its anatomical structure, pathophysiological mechanism and multimodal image features.
RESUMO
A 21-year-old Caucasian man presented with a complaint of nyctalopia. Visual acuity in both eyes was 20/20 and anterior segment biomicroscopy results were unremarkable. Fundoscopy revealed peripheral avascular zones, minimal peripheral retinal exudation from the retinal vessels, peripheral retinal telangiectasias and anastomosis in both eyes, and retinal vascular dragging toward the temporal periphery in both eyes. Full field electroretinography showed that rod responses were almost absent and that cone responses were reduced. Macular optical coherence tomography showed normal structure in both eyes. Vascular changes were attributed to a subclinical form of familial exudative vitreoretinopathy. This was an interesting case due to the association of familial exudative vitreoretinopathy with rod-cone dystrophy.
Um homem caucasiano de 21 anos foi avaliado com queixa de nictalopia. A acuidade visual era 20/20 em ambos os olhos. Biomicroscopia do segmento anterior era normal. A fundoscopia revelava zonas avasculares periféricas, exsudação mínima dos vasos retinianos periféricos da retina, telangiectasias da retina periférica com anastomoses em ambos os olhos e deslocamento vascular da retina em direção a periferia temporal em ambos os olhos. O eletrorretinograma (ERG) de campo total apresentava respostas de bastonetes praticamente indetectáveis e redução das respostas de cones. A tomografia de coerência óptica (OCT) macular mostrava estrutura normal em AO. As alterações vasculares foram atribuídas à forma subclínica da vitreorretinopatia exsudativa familiar. Este é um caso interessante com a associação de vitreoretinopatia exsudativa familiar e distrofia de cones e bastonetes (RCD).