Shirodkar Anita R, Pathengay Avinash, Flynn Harry W
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, Florida 33136, USA.
Ophthalmic Surg Lasers Imaging. 2011 Aug 4;42 Online:e67-70. doi: 10.3928/15428877-20110728-01.
A 75-year-old woman developed acute-onset endophthalmitis following phacoemulsification in the left eye. She was treated with intravitreal injections of vancomycin, ceftazidime, and gentamicin. The patient had persistent visual loss in the left eye after treatment. Her best-corrected visual acuity was 2/200 in the left eye and examination revealed a pale disc, retinal hemorrhages, and multiple nerve fiber layer infarcts. Fluorescein angiography showed retinal vascular non-perfusion in the macula. On spectral-domain optical coherence tomography (SD-OCT), there was diffuse retinal thinning, absence of the foveal depression, and increased reflectivity of the nerve fiber and ganglion cell layers, but with an intact inner segment/outer segment junction. This case demonstrates SD-OCT features in macular infarction following intravitreal gentamicin, specifically changes involving the inner retina with a relatively intact outer retina.
一名75岁女性在左眼白内障超声乳化术后发生急性眼内炎。她接受了玻璃体内注射万古霉素、头孢他啶和庆大霉素治疗。治疗后患者左眼持续视力丧失。其左眼最佳矫正视力为2/200，检查发现视盘苍白、视网膜出血和多处神经纤维层梗死。荧光素血管造影显示黄斑区视网膜血管无灌注。在频域光学相干断层扫描（SD-OCT）上，可见视网膜弥漫性变薄，中央凹凹陷消失，神经纤维层和神经节细胞层反射率增加，但内节/外节连接完整。本病例展示了玻璃体内注射庆大霉素后黄斑梗死的SD-OCT特征，特别是涉及视网膜内层而外层相对完整的变化。
