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血栓性血小板减少性紫癜继发浆液性视网膜脱离 16 个月后视力完全恢复:病例报告及文献复习。

PROFOUND VISUAL RECOVERY AT 16 MONTHS AFTER RESOLUTION OF SEROUS RETINAL DETACHMENTS SECONDARY TO THROMBOTIC THROMBOCYTOPENIC PURPURA: CASE REPORT AND LITERATURE REVIEW.

机构信息

Department of Ophthalmology, Emory University, Atlanta, Georgia; and.

Palmetto Retina Center, West Columbia, South Carolina.

出版信息

Retin Cases Brief Rep. 2021 Jan 1;15(1):18-21. doi: 10.1097/ICB.0000000000000727.

Abstract

PURPOSE

To report a unique case of dramatic improvement in objective visual function during the recovery phase, after resolution of thrombotic thrombocytopenic purpura-related serous retinal detachments and to review prognostic trends in reported cases involving the macula.

METHODS

Observational case report and literature review.

RESULTS

A 36-year-old white woman with thrombotic thrombocytopenic purpura developed vision loss from serous retinal detachments in both eyes. Over a 16-month period, after both retinae remained attached, best-corrected visual acuity improved from 20/400 to 20/50 in both eyes with dramatic improvement on optical coherence tomography and autofluorescence imaging.

CONCLUSION

Although thrombotic thrombocytopenic purpura is a life-threatening illness, visual prognosis in patients with macula off serous retinal detachments appears excellent. Most cases reviewed in literature improved to baseline visual acuity, but recovery periods ranged from days to many months. Hyperautofluorescent granularity on autofluorescence photography may be an indicator of chronic retinal detachment and a more delayed visual recovery.

摘要

目的

报告一例血栓性血小板减少性紫癜相关浆液性视网膜脱离消退后客观视觉功能显著改善的独特病例,并回顾涉及黄斑的报告病例中的预后趋势。

方法

观察性病例报告和文献回顾。

结果

一名 36 岁白人女性患有血栓性血小板减少性紫癜,双眼均发生浆液性视网膜脱离导致视力丧失。经过 16 个月,当两只视网膜均保持附着状态后,最佳矫正视力从双眼 20/400 提高到 20/50,光学相干断层扫描和自发荧光成像显示显著改善。

结论

尽管血栓性血小板减少性紫癜是一种危及生命的疾病,但黄斑脱离浆液性视网膜脱离患者的视力预后似乎很好。文献中回顾的大多数病例都恢复到基线视力,但恢复时间从数天到数月不等。自发荧光摄影中的高自发荧光颗粒状可能是慢性视网膜脱离和更延迟的视觉恢复的指标。

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