罗氏斑的频域光学相干断层扫描
Spectral-domain optical coherence tomography of roth spots.
作者信息
Giovinazzo Jerome, Mrejen Sarah, Freund K Bailey
机构信息
*Vitreous, Retina, Macula Consultants of New York and the LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York; and †Department of Ophthalmology, New York University School of Medicine, New York, New York.
出版信息
Retin Cases Brief Rep. 2013 Summer;7(3):232-5. doi: 10.1097/ICB.0b013e31828abe7f.
PURPOSE
To describe the retinal findings of subacute bacterial endocarditis, their evolution after treatment, and analysis with spectral-domain optical coherence tomography.
METHODS
Retrospective chart review.
RESULTS
A 21-year-old man presented with the sudden onset of a central scotoma in his left eye because of a sub-internal limiting membrane hemorrhage overlying the left fovea. When examined 2 weeks later, Roth spots were noted in his right eye. The patient was immediately referred to his internist and diagnosed with subacute bacterial endocarditis with cultures positive for Streptococcus viridans. He subsequently underwent aortic valve replacement surgery after 4 weeks of intravenous antibiotic therapy. When examined 4 weeks after valve replacement surgery, there was regression of the Roth spots.
CONCLUSION
The present case demonstrates the importance of a funduscopic examination in the early diagnosis and management of subacute bacterial endocarditis. The analysis of Roth spots with spectral-domain optical coherence tomography suggested that they were septic emboli.
目的
描述亚急性细菌性心内膜炎的视网膜表现、治疗后的演变情况，并通过光谱域光学相干断层扫描进行分析。
方法
回顾性病历审查。
结果
一名21岁男性因左眼黄斑中心凹上方的内界膜下出血突然出现左眼中央暗点。2周后检查时，右眼发现Roth斑。患者立即被转诊至内科医生处，诊断为亚急性细菌性心内膜炎，草绿色链球菌培养阳性。在静脉抗生素治疗4周后，他随后接受了主动脉瓣置换手术。瓣膜置换手术后4周检查时，Roth斑消退。
结论
本病例证明了眼底检查在亚急性细菌性心内膜炎早期诊断和管理中的重要性。用光谱域光学相干断层扫描分析Roth斑表明它们是脓毒性栓子。
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