Pesin S R, Katz L J, Augsburger J J, Chien A M, Eagle R C
Glaucoma Department, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107.
Ophthalmology. 1990 Jan;97(1):76-84. doi: 10.1016/s0161-6420(90)32639-8.
Acute angle-closure glaucoma from a spontaneous massive hemorrhagic retinal or choroidal detachment occurred in five eyes. The source of the hemorrhagic detachment was a disciform macular lesion in all instances. The mechanism for the angle closure is the abrupt forward displacement of the lens-iris diaphragm resulting from the massively detached choroid and retina. Four of the five patients had either systemic hypertension or a primary or anticoagulant-induced clotting disorder. All patients underwent ultrasonographic studies, and one patient had magnetic resonance imaging (MRI) to rule out melanoma. Only one eye required enucleation for pain relief. Glaucoma medication, cyclophotocoagulation, or retrobulbar alcohol controlled the other four eyes. The clinical, ultrasonographic, MRI, and histopathologic features of this rare condition are described, and an updated therapeutic approach is discussed.
5只眼睛发生了因自发性大量出血性视网膜或脉络膜脱离所致的急性闭角型青光眼。所有病例中出血性脱离的来源均为黄斑盘状病变。房角关闭的机制是大量脱离的脉络膜和视网膜导致晶状体-虹膜隔突然向前移位。5例患者中有4例患有系统性高血压或原发性或抗凝剂引起的凝血障碍。所有患者均接受了超声检查，1例患者进行了磁共振成像（MRI）以排除黑色素瘤。只有1只眼睛因疼痛缓解需要眼球摘除术。青光眼药物、睫状体光凝术或球后注射酒精控制了其他4只眼睛。描述了这种罕见疾病的临床、超声、MRI和组织病理学特征，并讨论了最新的治疗方法。
