Blodi B A, Johnson M W, Gass J D, Fine S L, Joffe L M
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, FL 33101.
Ophthalmology. 1990 Dec;97(12):1654-9. doi: 10.1016/s0161-6420(90)32365-5.
Severe bilateral visual loss attributable to multiple retinal arteriolar occlusions occurred in four young women within 24 hours after childbirth. In two patients, labor was complicated by preeclampsia requiring cesarean section. One patient was suffering from pancreatitis. None had connective tissue disease or antecedent trauma. Ophthalmoscopy and fluorescein angiography revealed evidence of multiple superficial peripapillary and macular patches of ischemic retinal whitening simulating Purtscher's retinopathy. By 8 weeks, the white patches were resolving in all eyes and visual acuity had significantly improved in three of the four patients. The pathogenesis of this disorder is unknown but may involve arteriolar obstruction by complement-induced leukoemboli formed during parturition.
四名年轻女性在产后24小时内出现了因多发性视网膜小动脉阻塞导致的严重双侧视力丧失。其中两名患者分娩时并发先兆子痫，需行剖宫产。一名患者患有胰腺炎。所有患者均无结缔组织病或既往外伤史。眼底检查和荧光素血管造影显示，多个视乳头周围和黄斑区浅层缺血性视网膜变白，类似Purtscher视网膜病变。至8周时，所有患眼的白色斑块均在消退，四名患者中有三名视力显著改善。这种疾病的发病机制尚不清楚，但可能与分娩过程中补体诱导的白细胞栓子导致的小动脉阻塞有关。
