Khan Mohammed Ali, Ho Allen C, Spirn Marc J
Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania.
Retin Cases Brief Rep. 2017;11(1):4-6. doi: 10.1097/ICB.0000000000000273.
To report a case of transient, bilateral cotton spots after initiation of macitentan, an endothelin receptor antagonist used for the treatment of pulmonary arterial hypertension.
Case report.
A 76-year-old woman with WHO Class IIIb pulmonary arterial hypertension was referred for evaluation of bilateral cotton-wool spots 1 week after starting macitentan therapy. The patient was asymptomatic and visual acuity was 20/25 in each eye. Fluorescein angiography and optical coherence tomography were completed. Given lack of symptoms and alternative treatment options, the patient was observed closely. The cotton-wool spots resolved 8 weeks after presentation and visual acuity remained stable at 20/25. Throughout the observation period, average mean arterial pressure was within normal limits at 84.8.
In patients using endothelin receptor antagonists, medication side effect should be considered in the differential diagnosis of cotton-wool spots.
报告1例在开始使用马西替坦（一种用于治疗肺动脉高压的内皮素受体拮抗剂）后出现短暂双侧棉絮斑的病例。
病例报告。
一名76岁、世界卫生组织功能分级为IIIb级的肺动脉高压女性患者，在开始马西替坦治疗1周后因双侧棉絮斑接受评估。患者无症状，每只眼视力均为20/25。完成了荧光素血管造影和光学相干断层扫描。鉴于患者无症状且有其他治疗选择，对其进行密切观察。棉絮斑在出现后8周消退，视力保持稳定，仍为20/25。在整个观察期内，平均动脉压正常，为84.8。
在使用内皮素受体拮抗剂的患者中，棉絮斑的鉴别诊断应考虑药物副作用。
