So Keitetsu, Shinoda Kei, Watanabe Emiko, Mashiko Toru, Mizota Atsushi
*Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, Kawasaki, Japan †Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Itabashi, Tokyo, Japan.
Retin Cases Brief Rep. 2012 Spring;6(2):142-4. doi: 10.1097/ICB.0b013e3182160913.
Retinal vascular abnormalities are rare in patients with Duchenne muscular dystrophy. We present a patient with Duchenne muscular dystrophy who developed severe proliferative retinopathy for which vitrectomy was successfully performed in one eye.
Case presentation. A 23-year-old Japanese man with Duchenne muscular dystrophy complicated by cardiac and respiratory insufficiency had reduced vision in both eyes. His best-corrected visual acuity was 0.01 in the right eye and hand movements in the left eye. Ophthalmoscopy showed vitreous hemorrhage and proliferative tissue attached to the optic disk bilaterally. Ultrasound echography showed tractional retinal detachment in the left eye.
Because general anesthesia was considered to be a high risk, vitrectomy, lensectomy, neovascular membrane removal, endolaser photocoagulation, and silicone oil injection were performed under local anesthesia on the right eye. After removal of the silicone oil and intraocular lens implantation, the best-corrected visual acuity was 0.8 in the right eye. Vitrectomy was performed on the left eye, but the retina could not be attached.
The etiology of the proliferative retinopathy in our case is not known. Because early treatment has the potential to improve and maintain vision, we recommend periodic fundus examinations in patients with Duchenne muscular dystrophy.
视网膜血管异常在杜氏肌营养不良患者中较为罕见。我们报告一名患有杜氏肌营养不良的患者,其发生了严重的增殖性视网膜病变,其中一只眼睛成功地进行了玻璃体切除术。
病例报告。一名23岁患有杜氏肌营养不良并伴有心脏和呼吸功能不全的日本男性双眼视力下降。他的最佳矫正视力右眼为0.01,左眼为手动。眼底检查显示双眼玻璃体出血和附着在视盘上的增殖组织。超声检查显示左眼有牵拉性视网膜脱离。
由于考虑到全身麻醉风险高,右眼在局部麻醉下进行了玻璃体切除术、晶状体切除术、新生血管膜切除术、眼内激光光凝术和硅油注入术。取出硅油并植入人工晶状体后,右眼最佳矫正视力为0.8。左眼进行了玻璃体切除术,但视网膜未能复位。
我们病例中增殖性视网膜病变的病因尚不清楚。由于早期治疗有可能改善和维持视力,我们建议对杜氏肌营养不良患者进行定期眼底检查。