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[双眼后极部神经上皮浆液性脱离提示急性白血病]

[Bilateral serous detachment of neuroepithelium of the posterior pole disclosing acute leukemia].

作者信息

Riss J M, Kaplanski G, Righini-Chossegros M, Harle J R, Escoffier P, Saracco J B

机构信息

Clinique ophtalmologique, CHU La Timone, Marseille.

出版信息

J Fr Ophtalmol. 1990;13(11-12):563-8.

PMID:2081849
Abstract

A 51 year-old woman presented with sudden loss of vision secondary to serous neuroretinal detachments of both maculas. Fluorescein angiography revealed multiple hyperfluorescent pin-point dots in the early phases. The areas of fluorescein hyperfluorescence became more diffuse as dye leaked into the subretinal space. The diagnostic of acute monoblastic leukemia was made. Following treatment, her vision improved. Fundus examination at that time showed resolution of the bilateral serous retinal detachment. She died one month after the onset of visual complaints and autopsy was refused. There have been 14 previous reports of acute leukemia with serous retinal detachment. In most cases, retinal detachment occurred as the presenting sign or during relapse of the systemic disease. It was often bilateral and located in the posterior pole. Histopathologic studies showed leukemic infiltration of the choroid with areas of degeneration and proliferation of the retinal pigment epithelium. Angiographic findings are similar to what is observed in choroidal ischemia. The relationships with macular serous retinal detachment and choriocapillaris occlusion are discussed.

摘要

一名51岁女性因双眼黄斑部浆液性神经视网膜脱离导致视力突然丧失前来就诊。荧光素血管造影显示早期有多个高荧光小点。随着染料渗漏到视网膜下间隙,荧光素高荧光区域变得更加弥散。诊断为急性单核细胞白血病。经过治疗,她的视力有所改善。当时的眼底检查显示双侧浆液性视网膜脱离消退。她在出现视力问题一个月后去世,家属拒绝尸检。此前已有14例急性白血病伴浆液性视网膜脱离的报道。在大多数情况下,视网膜脱离是全身疾病的首发症状或复发时出现。通常为双侧性,位于后极部。组织病理学研究显示脉络膜有白血病浸润,伴有视网膜色素上皮的变性和增生区域。血管造影表现与脉络膜缺血所见相似。本文讨论了其与黄斑部浆液性视网膜脱离和脉络膜毛细血管闭塞的关系。

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