Gaur Nripen, Singh Pallavi, Chawla Rohan, Takkar Brijesh
Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, Delhi, India.
BMJ Case Rep. 2017 Feb 22;2017:bcr2016218908. doi: 10.1136/bcr-2016-218908.
A 19-year-old man presented with unilateral sudden onset vision loss following an intra-articular triamcinolone injection in the right temporomandibular joint. At fundus examination emboli of triamcinolone were visible in multiple retinal arteries. Choroidal ischaemia and occlusion of the central retinal artery and its branches were documented at fluorescein angiography. Optical coherence tomography revealed significant thickening of the inner retinal layers. Optical coherence tomography angiography clearly demonstrated an abrupt cut-off of flow in a vessel below the optic disc. Lack of perfusion of the superficial and deep retinal plexuses beyond the areas of embolisation and at the posterior pole was also appreciated. The visual outcome was poor despite treatment.
一名19岁男性在右侧颞下颌关节进行关节内曲安奈德注射后出现单侧突发视力丧失。眼底检查可见多条视网膜动脉中有曲安奈德栓子。荧光素血管造影显示脉络膜缺血以及视网膜中央动脉及其分支阻塞。光学相干断层扫描显示视网膜内层明显增厚。光学相干断层扫描血管造影清楚地显示视盘下方血管内血流突然中断。还可观察到栓塞区域以外及后极部的视网膜浅、深丛缺乏灌注。尽管进行了治疗,视力预后仍较差。