Moreno Páramo D, Rayón Rodríguez M A, García Leonardo J I
Departamento de Retina y Vítreo, Hospital General de México «Dr. Eduardo Liceaga», Ciudad de México, Estados Unidos Mexicanos.
Departamento de Retina y Vítreo, Hospital General de México «Dr. Eduardo Liceaga», Ciudad de México, Estados Unidos Mexicanos.
Arch Soc Esp Oftalmol (Engl Ed). 2019 Mar;94(3):141-144. doi: 10.1016/j.oftal.2018.10.009. Epub 2018 Dec 14.
Combined central retinal artery and vein occlusion is uncommon in adults and even more so in young people. The main origins are vasculitis and thromboembolic disorders. The prognosis is poor due to irreversible visual loss and the development of neovascular glaucoma (NVG). A 14 year-old male arrived at the clinic complaining of sudden and painless visual loss in the left eye. Best corrected visual acuity was light perception with clinical and fluoro-angiographic findings characteristic of combined central retinal artery and vein occlusion in his left eye. The findings in the systemic and laboratory studies led to a diagnosis of systemic lupus erythematosus (SLE) and antiphospholipid syndrome. The patient received treatment with steroids and oral anticoagulant. Seven days later, due to prolonged coagulation time, he presented with a vitreous haemorrhage. He was then treated with intravitreal ranibizumab in order to prevent NVG. Afterwards, vitrectomy and retinal endophotocoagulation were performed. To the best of our knowledge, this is the first presentation of a male, paediatric with SLE and combined occlusion to be published in the literature, and is also the first case treated with antiangiogenic agents that has not developed NVG at 12 months of follow-up.
视网膜中央动静脉联合阻塞在成年人中并不常见，在年轻人中更为罕见。主要病因是血管炎和血栓栓塞性疾病。由于不可逆转的视力丧失和新生血管性青光眼（NVG）的发生，预后较差。一名14岁男性到诊所就诊，主诉左眼突然无痛性视力丧失。最佳矫正视力为光感，其临床和荧光血管造影结果显示左眼为视网膜中央动静脉联合阻塞。全身和实验室检查结果导致诊断为系统性红斑狼疮（SLE）和抗磷脂综合征。患者接受了类固醇和口服抗凝剂治疗。七天后，由于凝血时间延长，他出现了玻璃体积血。随后为预防NVG，对其进行了玻璃体内注射雷珠单抗治疗。之后，进行了玻璃体切除术和视网膜内光凝术。据我们所知，这是首例男性儿童SLE合并视网膜中央动静脉联合阻塞并发表于文献的病例，也是首例接受抗血管生成药物治疗且在12个月随访期内未发生NVG的病例。
