Cuadra Salvador A, Padberg Frank T, Turbin Roger E, Farkas Jeffrey, Frohman Larry P
University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ, USA.
J Vasc Surg. 2005 Oct;42(4):792-5. doi: 10.1016/j.jvs.2005.05.060.
A 57-year-old woman developed blindness during treatment for sarcoidosis-induced end-stage renal disease. An initial renal transplantation failed, and hemoaccess was maintained with multiple central catheters and upper extremity prosthetic arteriovenous grafts. A successful second transplantation eliminated her need for hemodialysis, but a right brachial to internal jugular graft remained patent. Progressive visual loss 2 years after transplantation prompted ophthalmic evaluation which initially revealed unilateral left optic nerve edema and visual loss, ultimately worsening over several months to no light perception in the left eye, 20/60 vision in the right eye, and bilateral papilledema. Arteriography demonstrated cerebral venous hypertension attributed to the functioning hemoaccess graft. Permanent graft occlusion normalized the papilledema, and visual field defects in the right eye and visual acuity returned to 20/20 in the right eye.
一名57岁女性在结节病所致终末期肾病的治疗过程中出现失明。首次肾移植失败，通过多个中心静脉导管和上肢人工动静脉移植物维持血液通路。第二次移植成功，使她不再需要血液透析，但右肱动脉至颈内静脉移植物仍保持通畅。移植后2年出现进行性视力丧失，促使眼科评估，最初发现单侧左视神经水肿和视力丧失，最终在数月内恶化，左眼无光感，右眼视力为20/60，双侧视乳头水肿。血管造影显示脑静脉高压归因于功能正常的血液通路移植物。永久性移植物闭塞使视乳头水肿恢复正常，右眼视野缺损消失，右眼视力恢复至20/20。
