Ecsedy Mónika, Csákány Béla, Kovács Illés, Resch Miklós, Nagy Zoltán, Récsán Zsuzsa
Szemészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Mária u. 39., 1085.
Orv Hetil. 2018 Jun;159(24):985-990. doi: 10.1556/650.2018.30966.
We present cases of blinding spontaneous suprachoroidal haemorrhage in anticoagulant taking wet-AMD patients. A retrospective study has been performed to present the clinical course, management and final outcome of spontaneous suprachoroidal haemorrhage in 7 eyes of six age-related macular degeneration patients seen in our clinic from January 2016 to April 2017. All patients were on chronic oral anticoagulant therapy because of cardiovascular disorder. In one patient, haematological disorder was also present modifying significantly the haemostasis. All eyes received prior anti-VEGF treatment for exsudative AMD. Acute angle closure glaucoma - with no response to topical and oral IOP lowering therapy - was the most frequent ocular complication in our cases. The final visual prognosis was usually very poor. The risk of spontaneous suprachoroidal haemorrhage is increased in wet-AMD patients who are on anticoagulant therapy. To prevent this blinding condition, a stronger communication between ophthalmologists and cardiologists would be beneficial, with an ophthalmological check-up in this group of patients before and during the use of anticoagulants. Orv Hetil. 2018, 159(24): 985-990.
我们报告了正在接受抗凝治疗的湿性年龄相关性黄斑变性（wet-AMD）患者发生致盲性自发性脉络膜上腔出血的病例。我们进行了一项回顾性研究，以呈现2016年1月至2017年4月在我们诊所就诊的6例年龄相关性黄斑变性患者7只眼中自发性脉络膜上腔出血的临床过程、治疗及最终结局。所有患者因心血管疾病接受慢性口服抗凝治疗。1例患者还存在血液系统疾病，显著改变了止血功能。所有患眼此前均接受过抗血管内皮生长因子（anti-VEGF）治疗以治疗渗出性AMD。急性闭角型青光眼——对局部及口服降眼压治疗无反应——是我们病例中最常见的眼部并发症。最终视力预后通常很差。接受抗凝治疗的湿性AMD患者发生自发性脉络膜上腔出血的风险增加。为预防这种致盲性疾病，眼科医生与心脏病专家之间加强沟通将有益，在这类患者使用抗凝剂之前及期间进行眼科检查。《匈牙利医学周报》。2018年，159(24): 985 - 990。
