一名新生血管性青光眼患者在血液透析期间反复出现眼压升高。
Recurrent intraocular pressure elevation during hemodialysis in a patient with neovascular glaucoma.
作者信息
Song Won Kyung, Ha Seung Joo, Yeom Ho Yeup, Seoung Gong Jae, Hong Young Jae
机构信息
The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine Hospital, Seoul, Korea.
出版信息
Korean J Ophthalmol. 2006 Jun;20(2):109-12. doi: 10.3341/kjo.2006.20.2.109.
PURPOSE
To report a patient with symptomatic intraocular pressure (lOP) elevation in an eye with neovascular glaucoma (NVG) during hemodialysis.
METHODS
Case report.
RESULTS
Recurrent episodes of severe ocular pain and elevated IOP in the NVG eye were noted during hemodialysis in a 29-year-old man. The patient was recently diagnosed at our ophthalmology clinic with NVG due to central retinal vein occlusion. IOP was temporarily controlled after the Ahmed valve implantation. However, after the fibrous membrane developed and occluded the tip of the Ahmed valve, IOP elevation during hemodialysis recurred. Further treatments with intravenous mannitol, oral carbonic anhydrase inhibitor, topical antiglaumatic agents and subconjunctival 5-fluorouracil (5-FU) injections all failed to control relapsing pain and IOP elevation. Eventually, evisceration and hydroxyappatite implantation were performed.
CONCLUSIONS
Physicians must be alert to the possibility of IOP elevation in glaucomatous eyes during hemodialysis.
目的
报告1例血液透析期间新生血管性青光眼（NVG）患眼出现症状性眼压（IOP）升高的患者。
方法
病例报告。
结果
1例29岁男性在血液透析期间，NVG患眼反复出现严重眼痛和IOP升高。该患者近期在我们眼科门诊因视网膜中央静脉阻塞被诊断为NVG。植入艾哈迈德引流阀后眼压得到暂时控制。然而，在纤维膜形成并阻塞艾哈迈德引流阀尖端后，血液透析期间眼压再次升高。静脉注射甘露醇、口服碳酸酐酶抑制剂、局部使用抗青光眼药物以及结膜下注射5-氟尿嘧啶（5-FU）等进一步治疗均未能控制复发性疼痛和眼压升高。最终，实施了眼球摘除术并植入羟基磷灰石。
结论
医生必须警惕青光眼患者在血液透析期间眼压升高的可能性。
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