Saxena Sandeep, Mishra Nibha, Meyer Carsten H, Akduman Levent
Department of Ophthalmology, King George's Medical University, Lucknow, Uttar Pradesh, India.
BMJ Case Rep. 2013 Oct 21;2013:bcr2013201415. doi: 10.1136/bcr-2013-201415.
A 53-year-old man presented with sudden painless diminution of vision in his right eye for 3 days. His fundus examination showed diffuse whitening of the retina with a cherry red spot at the fovea with cilioretinal artery sparing. On fluorescein angiography delayed arteriovenous transit was observed. Three-dimensional spectral domain optical coherence tomography was used to assess retinal nerve fibre layer thickness and average macular central subfield thickness on days 3, 7, 30 and 90. Marked retinal oedema due to ischaemia was observed on day 3 of occurrence of central retinal artery occlusion. On day 7, significant decrease in retinal nerve fibre thickness and macular thickness was noted suggestive of acute reperfusion injury. Retinal nerve fibre layer thickness and macular thickness returned to near normal on day 30 due to restoration of blood supply with wash out of stress mediators. Retinal atrophy was observed on day 90.
一名53岁男性因右眼突发无痛性视力下降3天前来就诊。眼底检查显示视网膜弥漫性变白，黄斑区有樱桃红斑，睫状视网膜动脉未受累。荧光素血管造影显示动静脉延迟。在第3天、第7天、第30天和第90天使用三维光谱域光学相干断层扫描评估视网膜神经纤维层厚度和黄斑中心子区域平均厚度。视网膜中央动脉阻塞发生后第3天观察到因缺血导致的明显视网膜水肿。第7天，视网膜神经纤维厚度和黄斑厚度显著下降，提示急性再灌注损伤。由于血液供应恢复且应激介质清除，第30天视网膜神经纤维层厚度和黄斑厚度恢复至接近正常。第90天观察到视网膜萎缩。
