Goshe Jeffrey M, Platt Sean, Yeaney Gabrielle, Singh Arun D
*Cole Eye Institute, Cleveland Clinic, Cleveland, OH; and †Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH.
Cornea. 2017 Jan;36(1):116-118. doi: 10.1097/ICO.0000000000001017.
To report a case of nonresolving lymphangiectasia haemorrhagica conjunctivae (LHC) successfully treated with surgical drainage.
Retrospective case report.
A 17-year-old white girl presented with a history of a large red lesion affecting her right eye. Approximately 1 year earlier, she had noticed a small painless "red spot" affecting the inferior aspect of the conjunctiva of her right eye. Three months before presentation, she noticed a sudden increase in the size of the lesion. There was no history of trauma, and she was not a contact lens wearer. Her medical history was remarkable for a remote seizure disorder which had been stable on levetiracetam. Magnetic resonance imaging/magnetic resonance angiography of the brain and orbits was unremarkable. Anterior segment fluorescein angiography did not show any flow in the lesion, indicating a lymphatic origin of channels. Surgical drainage of the lesion was performed while sparing the affected conjunctiva resulting in an excellent cosmetic outcome. Incisional biopsy confirmed the diagnosis of LHC. The patient remained free of recurrence 6 months after the procedure.
Nonresolving LHC can be managed successfully with conjunctival sparing surgical drainage with an excellent cosmetic outcome.
报告一例经手术引流成功治疗的结膜出血性淋巴管扩张症(LHC)病例。
回顾性病例报告。
一名17岁白人女孩因右眼出现一个大的红色病变前来就诊。大约1年前,她注意到右眼结膜下方有一个无痛的小“红点”。就诊前3个月,她发现病变大小突然增大。无外伤史,她也不佩戴隐形眼镜。她有癫痫病史,曾服用左乙拉西坦病情稳定。脑部和眼眶的磁共振成像/磁共振血管造影未见异常。眼前段荧光血管造影显示病变处无血流,提示淋巴管起源。在保留受累结膜的情况下对病变进行手术引流,获得了极佳的美容效果。切开活检确诊为LHC。术后6个月患者未复发。
对于无法自行消退的LHC,采用保留结膜的手术引流可成功治疗,美容效果良好。