Stein Eye Institute, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.
Retin Cases Brief Rep. 2021 Mar 1;15(2):131-134. doi: 10.1097/ICB.0000000000000764.
To report a case of branch retinal artery wall rupture and subsequent branch retinal artery occlusion occurring during a routine pars plana vitrectomy with epiretinal membrane and internal limiting membrane peeling.
Case report. Multimodal imaging including fluorescein angiography, spectral domain optical coherence tomography (OCT), en face OCT, and OCT angiography were performed.
An 86-year-old woman presented with a symptomatic epiretinal membrane in the right eye. Pars plana vitrectomy with epiretinal membrane and internal limiting membrane peel was performed. During the peel, spontaneous preretinal and intraretinal hemorrhage emanating from an adjacent branch retinal artery developed. At postoperative Week 1, OCT showed retinal thinning and hyperreflectivity suggestive of vascular accident. At postoperative Year 1, OCT imaging revealed retinal atrophy while fluorescein angiography demonstrated the arterial occlusion, and OCT angiography illustrated reduction in retinal perfusion in the region of the branch retinal artery occlusion.
The authors report an unusual case of retinal arterial wall rupture and hemorrhaging during routine pars plana vitrectomy with membrane peel resulting in a branch retinal artery occlusion and subsequent retinal atrophy. Surgeons must limit stress on the underlying retina during membrane peel to avoid this surgical complication.
报告一例在常规玻璃体切除术联合视网膜内界膜和视网膜外膜剥除术中发生分支视网膜动脉壁破裂和随后分支视网膜动脉阻塞的病例。
病例报告。进行了多模态成像，包括荧光素血管造影、谱域光学相干断层扫描（OCT）、面 OCT 和 OCT 血管造影。
一名 86 岁女性因右眼有症状的视网膜内界膜而就诊。行玻璃体切除术联合视网膜内界膜和视网膜外膜剥除术。在剥除过程中，自发出现来自相邻分支视网膜动脉的视网膜前和视网膜内出血。术后第 1 周，OCT 显示视网膜变薄和高反射性，提示血管意外。术后第 1 年，OCT 成像显示视网膜萎缩，荧光素血管造影显示动脉阻塞，OCT 血管造影显示分支视网膜动脉阻塞区域的视网膜灌注减少。
作者报告了一例在常规玻璃体切除术联合膜剥除术中发生视网膜动脉壁破裂和出血的罕见病例，导致分支视网膜动脉阻塞和随后的视网膜萎缩。外科医生在进行膜剥除时必须限制对底层视网膜的压力，以避免这种手术并发症。
