Yu Gina, Sun Peng, van Zyl Tavé, Tandias Rachel, Arroyo Jorge G
Department of Ophthalmology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
University of Michigan Medical School, Ann Arbor, Michigan.
Retin Cases Brief Rep. 2018;12(4):300-304. doi: 10.1097/ICB.0000000000000501.
To describe a case of a central retinal vein occlusion in a young patient with a history of eosinophilic pneumonia.
A retrospective case report of a 45-year-old woman with acute painless vision loss for 9 days after multiple episodes of eosinophilic pneumonia and thalamic stroke. Fluorescein angiography, spectral domain optical coherence tomography, and clinical examination were performed. She was then treated with intravitreal bevacizumab and pan-retinal photocoagulations.
Retinal examination revealed tortuosity and dilatation of all branches of the central retinal vein and flame-shaped hemorrhages in all four quadrants of the right eye associated with cystoid macular edema, optic disc edema, and cotton wool spots. The left eye had mild venous dilatation and tortuosity with a few dot retinal hemorrhages in the far temporal periphery. The cystoid macular edema resolved after one intravitreal injection of bevacizumab and remained resolved at the most recent follow-up. Fluorescein angiography at the most recent follow-up revealed vasculitis in the far periphery of the nontreated eye.
Central retinal vein occlusion in young patients is a rare condition often presenting as a manifestation of an underlying inflammatory or hematological disorder. Combined anti-vascular endothelial growth factor treatment and pan-retinal photocoagulation may have resolved the associated cystoid macular edema in this case, although continued observation is necessary.
描述一例患有嗜酸性粒细胞性肺炎的年轻患者发生视网膜中央静脉阻塞的病例。
对一名45岁女性进行回顾性病例报告，该患者在多次发生嗜酸性粒细胞性肺炎和丘脑卒中后出现急性无痛性视力丧失9天。进行了荧光素血管造影、频域光学相干断层扫描和临床检查。随后对她进行了玻璃体腔内注射贝伐单抗和全视网膜光凝治疗。
视网膜检查显示右眼视网膜中央静脉所有分支迂曲扩张，四个象限均有火焰状出血，伴有黄斑囊样水肿、视盘水肿和棉絮斑。左眼有轻度静脉扩张和迂曲，颞侧远周边有少量点状视网膜出血。玻璃体腔内注射一次贝伐单抗后黄斑囊样水肿消退，在最近一次随访时仍未复发。最近一次随访时的荧光素血管造影显示未治疗眼的远周边存在血管炎。
年轻患者的视网膜中央静脉阻塞是一种罕见疾病，常表现为潜在炎症或血液系统疾病的一种表现。在本病例中，联合抗血管内皮生长因子治疗和全视网膜光凝可能已解决了相关的黄斑囊样水肿，尽管仍需持续观察。
