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高原性非缺血型视网膜中央静脉阻塞继发睫状视网膜动脉阻塞的高压氧后期治疗。

Late hyperbaric oxygen treatment of cilioretinal artery occlusion with nonischemic central retinal vein occlusion secondary to high altitude.

机构信息

1 Department of Ophthalmology, Sarikamis Military Hospital , Kars, Turkey .

出版信息

High Alt Med Biol. 2014 Apr;15(1):84-8. doi: 10.1089/ham.2013.1086.

Abstract

AIM

To report a case of cilioretinal artery occlusion (CRAO) with central retinal vein occlusion (CRVO) after a journey to high altitude region and the use of late period hyperbaric oxygen (HBO) therapy successfully.

CASE REPORT

A previously healthy 48-year-old lowlander woman was admitted to our department for sudden blurred vision in her right eye started at 2 weeks prior to examination. The patient had a history of 1-month exposure to high altitude that finished a day before the onset of her complaints. The best corrected visual acuity (BCVA) was 10/20 in the right eye (RE) and 10/10 in the left eye. Fundus examination of the RE revealed whitening of the retina along the distribution of cilioretinal artery, sparing fovea, flame-shaped hemorrhages, and roth spots with minimally dilated and tortuous retinal veins. Visual field analysis revealed centrocecal scotoma. The patient was treated by a daily session of 2 h of HBO at 2.5 atmosphere absolute for 11 days. BCVA rised to a level of 20/20 for the RE and the scotomas were disappeared immediately after using of the HBO treatment.

CONCLUSION

CRVO related CRAO should be regarded as a rare complication of exposure to high altitude and HBO seems to be the treatment of choice of high altitude related co-occurence of CRVO and CRAO in the late period.

摘要

目的

报告一例因高原旅行和后期高压氧(HBO)治疗而导致的睫状视网膜动脉阻塞(CRAO)合并视网膜中央静脉阻塞(CRVO)病例。

病例报告

一名既往健康的 48 岁低海拔女性因右眼突然视力模糊而于检查前 2 周入院。患者有 1 个月的高原暴露史,在发病前一天结束。最佳矫正视力(BCVA)右眼为 10/20,左眼为 10/10。右眼眼底检查显示沿睫状视网膜动脉分布的视网膜变白,黄斑区保留,火焰状出血和 Roth 斑,视网膜静脉轻度扩张和扭曲。视野分析显示中心暗点。患者接受了每天 2 小时、2.5 个大气压绝对压力的 11 次 HBO 治疗。右眼 BCVA 提高至 20/20,立即使用 HBO 治疗后暗点消失。

结论

CRVO 相关的 CRAO 应被视为高原暴露的罕见并发症,HBO 似乎是高原相关 CRVO 和 CRAO 后期同时发生的治疗选择。

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