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急性酒精性胰腺炎中的类Purtscher视网膜病变。

Purtscher-like retinopathy in acute alcoholic pancreatitis.

作者信息

Nema Nitin, Ishrat Saba, Verma Abha, Kela Manoj

机构信息

Department of Ophthalmology, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India.

Department of Surgery, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India.

出版信息

Oman J Ophthalmol. 2016 May-Aug;9(2):110-2. doi: 10.4103/0974-620X.184531.

Abstract

A 23-year-old man with a history of alcoholism presented with vomiting, fever, and sharp epigastric pain radiating to the back and flanks. He was diagnosed as a case of acute alcoholic pancreatitis on the basis of clinical findings and investigations. On the next day of presentation, he developed sudden bilateral visual loss. His best-corrected visual acuity was finger counting at one-foot distance in both eyes. He had diffuse whitening in the circumpapillary area, haloes around the retinal vessels (Purtscher flecken) and intra-retinal hemorrhages on ophthalmoscopic examination. Optical coherence tomography revealed bilateral macular edema. These findings were characteristic of Purtscher-like retinopathy. The patient showed systemic and visual improvement at 8 weeks follow-up after receiving the conventional treatment for acute alcoholic pancreatitis. This case emphasizes the importance of fundus examination by an ophthalmologist in the diagnosis of this rare under-diagnosed entity.

摘要

一名有酗酒史的23岁男性出现呕吐、发热及上腹部剧痛,并放射至背部和侧腹。根据临床表现和检查,他被诊断为急性酒精性胰腺炎。就诊次日,他突然出现双侧视力丧失。双眼最佳矫正视力为距1英尺处数指。眼底检查发现视乳头周围区域弥漫性变白、视网膜血管周围有光晕(普尔夏斑)及视网膜内出血。光学相干断层扫描显示双侧黄斑水肿。这些表现是类普尔夏视网膜病变的特征。在接受急性酒精性胰腺炎的常规治疗8周后随访时,患者全身情况及视力均有改善。该病例强调了眼科医生进行眼底检查对诊断这种罕见的、诊断不足的疾病的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a69/4932793/46b3f6a23ff2/OJO-9-110-g001.jpg

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