低血压性缺血性视神经病变与腹膜透析
Hypotensive ischemic optic neuropathy and peritoneal dialysis.
作者信息
Jackson T L, Farmer C K, Kingswood C, Vickers S
机构信息
The Sussex Eye Hospital, Brighton, United Kingdom.
出版信息
Am J Ophthalmol. 1999 Jul;128(1):109-11. doi: 10.1016/s0002-9394(99)00026-4.
PURPOSE
To report anterior ischemic optic neuropathy associated with systemic hypotension in a patient undergoing continuous ambulatory peritoneal dialysis.
METHODS
Case report. A 58-year-old man undergoing continuous ambulatory peritoneal dialysis developed painless blurred vision in both eyes and bilateral optic disk swelling with an altitudinal field defect in the left eye. Twenty-four-hour ambulatory blood pressure monitoring was requested in addition to other routine investigations.
RESULTS
Routine blood pressure measurement in the clinic was 130/86 mm Hg, but ambulatory blood pressure monitoring demonstrated pronounced early morning hypotension with individual readings as low as 91/41 mm Hg.
CONCLUSIONS
Renal dialysis can render patients hypotensive, and this may be associated with anterior ischemic optic neuropathy. The overnight drop in blood pressure may not be appreciated with routine blood pressure measurement. Therefore, 24-hour ambulatory blood pressure monitoring should be considered when investigating patients with suspected anterior ischemic optic neuropathy who are undergoing renal replacement.
目的
报告1例持续非卧床腹膜透析患者发生的与全身性低血压相关的前部缺血性视神经病变。
方法
病例报告。1例58岁正在接受持续非卧床腹膜透析的男性患者出现双眼无痛性视力模糊，双侧视盘肿胀，左眼有象限性视野缺损。除其他常规检查外，还要求进行24小时动态血压监测。
结果
门诊常规血压测量为130/86 mmHg，但动态血压监测显示清晨明显低血压，个别读数低至91/41 mmHg。
结论
肾脏透析可使患者血压降低，这可能与前部缺血性视神经病变有关。常规血压测量可能无法发现夜间血压下降情况。因此，在对怀疑患有前部缺血性视神经病变且正在接受肾脏替代治疗的患者进行检查时，应考虑进行24小时动态血压监测。
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