Stoumbos V D, Klein M L, Goodman S
Casey Eye Institute, Oregon Health Sciences University, Portland 97201-4197.
Ophthalmology. 1992 Dec;99(12):1833-9. doi: 10.1016/s0161-6420(92)31716-6.
The authors describe the clinical findings of three young women with the previously unreported association of Purtscher's-like retinopathy and chronic renal failure.
The authors reviewed the clinical records of three women with chronic renal failure who had been seen at the Oregon Health Sciences University with acute, profound visual loss associated with a severe vaso-occlusive Purtscher's-like retinopathy.
Two of the three patients previously had renal transplants, and both were experiencing allograft rejection. One of these two patients was undergoing hemodialysis. The retinopathy was bilateral in two patients, and unilateral in the third. Each of the 5 affected eyes had severe initial loss of vision to less than 20/400, and only one of these eyes had significant visual recovery. None of the patients had recent trauma, pancreatitis, autoimmune disease, or other condition known to be associated with Purtscher's-like retinopathy.
A retinal vaso-occlusive disorder resembling Purtscher's retinopathy can occur in patients with chronic renal failure, even in the absence of trauma, pancreatitis, or known autoimmune disease. While the precipitating factor(s) remains unclear, it appears that the retinopathy in this setting may be more severe and associated with a poorer visual prognosis.
作者描述了3名年轻女性的临床发现，她们患有此前未报告过的类似普尔夏视网膜病变与慢性肾衰竭的关联。
作者回顾了3名慢性肾衰竭女性的临床记录，她们在俄勒冈健康与科学大学就诊时出现了与严重血管闭塞性类似普尔夏视网膜病变相关的急性、严重视力丧失。
3名患者中有2名曾接受肾移植，且均出现同种异体移植排斥反应。这两名患者中的一名正在接受血液透析。视网膜病变在两名患者中为双侧性，在第三名患者中为单侧性。5只受累眼中的每只最初都有严重的视力丧失，降至20/400以下，且这些眼中只有一只视力有显著恢复。所有患者近期均无外伤、胰腺炎、自身免疫性疾病或其他已知与类似普尔夏视网膜病变相关的疾病。
即使没有外伤、胰腺炎或已知的自身免疫性疾病，慢性肾衰竭患者也可能发生类似普尔夏视网膜病变的视网膜血管闭塞性疾病。虽然促发因素尚不清楚，但在这种情况下，视网膜病变似乎可能更严重，且视力预后较差。
