Fischer Charlotte, Bruggemann Anne, Hager Annette, Callizo Planas Josep, Roider Johann, Hoerauf Hans
University Eye Clinic, Georg-August-Universität Göttingen, Göttingen, Germany.
Eye Clinic, University Medical Center Schleswig-Holstein, Lübeck, Germany.
J Ophthalmol. 2017;2017:9120892. doi: 10.1155/2017/9120892. Epub 2017 Jul 11.
Ocular vascular occlusions following intraocular procedures are a rare complication. We report a case series of patients with retinal vascular occlusions or anterior ischemic optic neuropathy (AION) after anterior and posterior segment surgery and demonstrate possible risk factors.
Observational case series.
In ten patients, vascular occlusions were observed within ten weeks after intraocular surgery: branch retinal arterial occlusion (BRAO) ( = 2), central retinal artery occlusion (CRAO) ( = 2), central retinal vein occlusion (CRVO) ( = 1), branch retinal vein occlusion (BRVO) ( = 1), anterior ischemic optic neuropathy (AION) ( = 3), and combined central artery and vein occlusion ( = 1). AION occurred later (27-69 d) than arterial occlusions (14-60 d) or venous occlusions (1-2 d). In all cases, either specific surgical manipulations or general vascular disorders were identified as risk factors. In addition to general cardiovascular risk factors (arterial hypertension = 6, diabetes mellitus = 4), internal workup disclosed bilateral stenosis of the carotid arteries ( = 1) and myeloproliferative syndrome ( = 1).
Vascular occlusions after surgical ocular procedures seem to be more frequent when cardiovascular diseases coexist. Surgical maneuvers and intra- or postoperative pressure changes may act as a triggering mechanism in patients with underlying systemic cardiovascular disorders. Affected patients should undergo thorough internal examination to identify possible underlying diseases.
眼内手术后发生的眼部血管阻塞是一种罕见的并发症。我们报告了一组在前段和后段手术后出现视网膜血管阻塞或前部缺血性视神经病变（AION）的患者病例系列，并展示了可能的危险因素。
观察性病例系列。
在10例患者中，眼内手术后10周内观察到血管阻塞：视网膜分支动脉阻塞（BRAO）（=2）、视网膜中央动脉阻塞（CRAO）（=2）、视网膜中央静脉阻塞（CRVO）（=1）、视网膜分支静脉阻塞（BRVO）（=1）、前部缺血性视神经病变（AION）（=3）以及中央动静脉联合阻塞（=1）。AION出现的时间（27 - 69天）比动脉阻塞（14 - 60天）或静脉阻塞（1 - 2天）晚。在所有病例中，特定的手术操作或一般血管疾病被确定为危险因素。除了一般心血管危险因素（动脉高血压=6、糖尿病=4）外，进一步检查发现双侧颈动脉狭窄（=1）和骨髓增殖综合征（=1）。
当合并心血管疾病时，眼内手术后血管阻塞似乎更常见。手术操作以及术中或术后压力变化可能在潜在全身性心血管疾病患者中起到触发机制的作用。受影响的患者应接受全面的内科检查以确定可能的潜在疾病。
