Fine L C, Petrovic' V, Irvine A R, Bhisitkul R B
Department of Ophthalmology, Retina Service, University of California-San Francisco, San Francisco, California 94143, USA.
Am J Ophthalmol. 2000 May;129(5):680-1. doi: 10.1016/s0002-9394(00)00361-5.
To describe a case of spontaneous central retinal artery occlusion in a young man with hemoglobin sickle cell disease.
Case report.
A 31-year-old African-American man with a history of hemoglobin sickle cell disease developed sudden painless loss of vision in the right eye. Medical history was remarkable for the recent history of a mild painful crisis, but no other systemic illness or contributing factors. Central retinal artery occlusion was diagnosed with retinal whitening, cherry red spot, and delayed arteriovenous transit on fluorescein angiography. Over the ensuing week, the patient had visual recovery to 20/60 in the absence of therapeutic intervention.
Central retinal artery occlusion has been reported in sickle cell hemoglobinopathies (ie, SS, S-thal, sickle trait, and sickle cell), but the association with sickle cell disease is rare. Most reports have described additional contributing factors, such as trauma or concomitant systemic illness, to help account for the central retinal artery occlusion. The present case suggests that sickle cell disease alone is sufficient for the development of central retinal artery occlusion.
描述一例患有血红蛋白镰状细胞病的年轻男性发生自发性视网膜中央动脉阻塞的病例。
病例报告。
一名31岁有血红蛋白镰状细胞病病史的非裔美国男性右眼突然无痛性视力丧失。病史中近期有轻度疼痛危象,但无其他全身性疾病或相关因素。通过视网膜变白、樱桃红斑以及荧光素血管造影显示动静脉传输延迟诊断为视网膜中央动脉阻塞。在接下来的一周内,患者未经治疗视力恢复到20/60。
镰状细胞血红蛋白病(即SS、S-地中海贫血、镰状性状和镰状细胞)中曾有视网膜中央动脉阻塞的报道,但与镰状细胞病的关联罕见。大多数报道描述了其他相关因素,如创伤或合并全身性疾病,以解释视网膜中央动脉阻塞。本病例表明,仅镰状细胞病就足以导致视网膜中央动脉阻塞。