Laumonier E, Labalette P, Morisot C, Mouriaux F, Dobbelaere D, Rouland J F
Hôpital Huriez, Centre Hospitalier Régional Universitaire de Lille, Lille.
J Fr Ophtalmol. 2005 May;28(5):490-6. doi: 10.1016/s0181-5512(05)81085-x.
Galactosemia is an inherited metabolic disorder due to a defect in one of the three enzymes required to fully metabolize the galactose in glucose: the galactose 1-phosphate uridyltransferase. Because this enzyme is present in the normal foetal liver since the tenth week of gestation, its defect cause congenital abnormality due to galactose accumulation, when the mother had taken milk during the pregnancy. It is mainly a liver pathology whereas the foetal cataract is rare. This latter is usually considered as the sole ophthalmic consequence of this disorder but exceptional ocular haemorrhages have also been described. We report the case of a neonate with galactosemia free from foetal cataract but presenting an unilateral vitreous haemorrhage. Retinal anomalies seen after vitrectomy are probably the source of the vitreous blood favoured by the coagulopathy associated with the neonatal disease. The causes of infant vitreous haemorrhages are often debated and their complications, especially severe amblyopia, require vitrectomy within the month following their discovery. In galactosemia, vitreous haemorrhage can be prevented by an early diagnosis and an appropriate treatment of the liver pathology.
半乳糖血症是一种遗传性代谢紊乱疾病,病因是完全代谢葡萄糖中的半乳糖所需的三种酶之一存在缺陷,即1-磷酸半乳糖尿苷转移酶。由于这种酶自妊娠第十周起就存在于正常胎儿肝脏中,所以当母亲在孕期摄入牛奶时,该酶的缺陷会因半乳糖积累而导致先天性异常。它主要是一种肝脏病变,而胎儿白内障较为罕见。后者通常被认为是这种疾病唯一的眼部后果,但也有罕见的眼部出血的报道。我们报告了一例患有半乳糖血症的新生儿病例,该患儿没有胎儿白内障,但出现了单侧玻璃体出血。玻璃体切除术后发现的视网膜异常可能是与新生儿疾病相关的凝血病导致玻璃体出血的根源。婴儿玻璃体出血的原因常常存在争议,其并发症,尤其是严重弱视,需要在发现后一个月内进行玻璃体切除术。在半乳糖血症中,早期诊断和对肝脏病变进行适当治疗可预防玻璃体出血。