Schneider C, Bord C, Misse P, Arnaud B, Schmitt-Bernard C F
Service d'Ophtalmologie, CMC Gui de Chauliac, C.H.U. de Montpellier, France.
J Fr Ophtalmol. 2002 Sep;25(7):731-2.
We report the first case of a patient in whom Ginkgo biloba extract proved to be the unique cause of spontaneous hyphema. Extensive ophthalmological and biological investigations were undertaken in order to assess the role of Ginkgo biloba: platelet numbering, hemostasis factors, Willebrand antigen, ristocetin cofactor, platelet glycoprotein immunophenotyping, glycoprotein expression after activation by thrombin, inflammatory markers, B-scan ultrasonography, and fluorescent iridography. No putative causes of hyphema were recorded other than Gingko biloba intake. The bleeding originated from the 12-o'clock position of the iris margin. Anamnesis identified Ginkgo biloba extract ingestion from 2 weeks before the appearance of the patient's visual trouble. Ginkgo biloba intake was stopped and the hemorrhage resolved with no recurrence during the 18 months of follow-up. Ginkgo biloba is known for platelet inhibition and is extensively used in the elderly because of its beneficial effects as a vascular protector. The clinical progression of the present case strongly suggests that Ginkgo biloba may cause hemorrhage and hyphema, even in the absence of any other predisposing factor.
我们报告了首例银杏叶提取物被证明是自发性前房积血唯一病因的病例。为评估银杏叶的作用，我们进行了广泛的眼科和生物学检查：血小板计数、止血因子、血管性血友病因子抗原、瑞斯托霉素辅因子、血小板糖蛋白免疫表型分析、凝血酶激活后的糖蛋白表达、炎症标志物、B超检查以及荧光虹膜造影。除摄入银杏叶外，未发现其他可能导致前房积血的病因。出血源自虹膜边缘12点位置。病史询问发现患者在出现视力问题前2周开始服用银杏叶提取物。停用银杏叶提取物后，出血在18个月的随访期间得以消退且未复发。银杏叶因具有抑制血小板的作用而闻名，并且因其作为血管保护剂的有益作用而在老年人中广泛使用。本病例的临床进展强烈提示，即使没有任何其他诱发因素，银杏叶也可能导致出血和前房积血。
