Hwang Ho Sik, Kang Seungbum
Department of Ophthalmology, Youngwol Medical Center, Korea; Department of Ophthalmology and Visual Sciences, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Retin Cases Brief Rep. 2012 Spring;6(2):187-8. doi: 10.1097/ICB.0b013e31822476d7.
To describe combined central retinal vein occlusion and central retinal artery occlusion in systemic lupus erythematosus patient.
An 18-year-old woman came to our clinic complaining of sudden marked visual loss in her right eye. Best-corrected visual acuity was only hand movement in the right eye. An examination of the right fundus revealed a pale and edematous retina with widespread flame hemorrhages, a swollen optic disk, engorged and tortuous retinal veins, and a cherry-red spot, leading to a diagnosis of combined central retinal vein occlusion and central retinal artery occlusion. Fluorescein angiography displayed disk edema and delayed arteriolar filling, with dilated veins that did not fill with fluorescein. Because of the presence of fever, she was referred to the department of internal medicine where she was diagnosed as having systemic lupus erythematosus and antiphospholipid syndrome. The patient received steroid and anticoagulant treatment. To prevent neovascular glaucoma, intense prophylactic panretinal photocoagulation was initiated 2 weeks later.
Despite these efforts, consequent retinal neovascularization and neovascular glaucoma were unavoidable. Filtering surgery was performed 1 month after prophylactic panretinal photocoagulation.
Although rare, combined central retinal vein and artery occlusion can occur in systemic lupus erythematosus patient.
描述系统性红斑狼疮患者合并视网膜中央静脉阻塞和视网膜中央动脉阻塞的情况。
一名18岁女性前来我院就诊，主诉右眼突然出现明显视力丧失。右眼最佳矫正视力仅为手动。右眼眼底检查发现视网膜苍白、水肿，伴有广泛的火焰状出血、视盘肿胀、视网膜静脉迂曲扩张以及樱桃红斑，诊断为视网膜中央静脉阻塞合并视网膜中央动脉阻塞。荧光素血管造影显示视盘水肿和动脉充盈延迟，静脉扩张且未被荧光素充盈。由于患者发热，转诊至内科，被诊断为系统性红斑狼疮和抗磷脂综合征。患者接受了类固醇和抗凝治疗。为预防新生血管性青光眼，2周后开始进行强化预防性全视网膜光凝。
尽管采取了这些措施，视网膜新生血管形成和新生血管性青光眼仍不可避免。在预防性全视网膜光凝1个月后进行了滤过手术。
尽管罕见，但系统性红斑狼疮患者可发生视网膜中央静脉和动脉合并阻塞。
