Park Jongseok, Lee Hoyoung, Kim Young Kook, Chae Jeong Don, Lee Hyun Joo
Department of Ophthalmology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2011 Oct;25(5):362-5. doi: 10.3341/kjo.2011.25.5.362. Epub 2011 Sep 20.
We report on a case of cholesterosis bulbi concurrent with secondary glaucoma. A 36-year-old man, with a history of long-standing retinal detachment in his right eye after the irrigation and aspiration of a congenital cataract, presented with a clinical picture of elevated intraocular pressure and ocular pain. Upon slit-lamp examination, we found a ciliary injection and a pseudohypopyon of polychromatic crystals. Gonioscopic examination revealed a large amount of crystals deposited on the trabecular meshwork and mild rubeosis iridis, but the neovascularization of the angle could not be clearly confirmed due to the presence of so many crystals. Pars plana vitrectomy was performed to remove clusters of crystals and bevacizumab was injected intravitreally to treat iris neovascularization. Aqueous aspirate was examined by light microscopy and the typical highly refringent cholesterol crystals were identified. Intraocular pressure returned to a normal level after the bevacizumab injection, although severe cholesterosis was still evident in the anterior chamber. To our knowledge, this would be the first Korean case of cholesterosis bulbi combined with chronic retinal detachment and presumed neovascular glaucoma, which was treated by pars plana vitrectomy and intravitreal bevacizumab injection.
我们报告一例并发继发性青光眼的眼球胆固醇沉着症。一名36岁男性，右眼先天性白内障行水分离及抽吸术后长期视网膜脱离，现出现眼压升高和眼痛的临床表现。裂隙灯检查发现睫状充血及多色性晶体假性前房积脓。前房角镜检查发现小梁网有大量晶体沉积及轻度虹膜红变，但由于晶体过多，房角新生血管无法明确确认。行玻璃体切割术以清除晶体团块，并玻璃体内注射贝伐单抗治疗虹膜新生血管。对房水抽吸物进行光学显微镜检查，鉴定出典型的高折射胆固醇晶体。注射贝伐单抗后眼压恢复正常水平，尽管前房内仍有明显的严重胆固醇沉着症。据我们所知，这是韩国首例眼球胆固醇沉着症合并慢性视网膜脱离及疑似新生血管性青光眼，通过玻璃体切割术和玻璃体内注射贝伐单抗进行治疗。
