Izzy Saef, Deeb Wissam, Peters George B, Mitchell Ann
Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Department of Ophthalmology, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
BMJ Case Rep. 2014 Oct 15;2014:bcr2014205016. doi: 10.1136/bcr-2014-205016.
A 45-year-old man with no significant medical history presented following an electric current injury (380 V). He developed multiple systemic injuries including third degree burns and after 1 week of hospitalisation he reported unilateral visual changes. Examination suggested the presence of optic nerve oedema without evidence of haemorrhage, exudate or vessel abnormality. This was considered to be related to the electric shock. A trial of corticosteroids was considered. He was followed up to 5 months in clinic and was noted to have developed unilateral optic atrophy and no other systemic manifestations. Initial and 5 months follow-up optic nerve colour photograph and optical coherence topography were documented. The present case highlights the fact that electric current injury can present with only a unilateral ischaemic optic neuropathy, the need for early diagnosis for timely treatment and the controversial role of corticosteroids.
一名45岁无重大病史的男性在遭受电流损伤(380V)后前来就诊。他出现了多处全身损伤,包括三度烧伤,住院1周后报告有单侧视力变化。检查提示存在视神经水肿,无出血、渗出或血管异常迹象。这被认为与电击有关。考虑使用皮质类固醇进行试验性治疗。他在门诊随访了5个月,发现出现了单侧视神经萎缩,无其他全身表现。记录了初始及5个月随访时的视神经彩色照片和光学相干断层扫描结果。本病例突出了电流损伤可仅表现为单侧缺血性视神经病变这一事实,强调了早期诊断以便及时治疗的必要性以及皮质类固醇的争议性作用。