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一例与持续性胎儿血管系统相关的非典型牵牛花综合征病例的术后随访。

Postoperative follow-up of a case of atypical morning glory syndrome associated with persistent fetal vasculature.

作者信息

Jiang Heng, Liang Youling, Long Kejun, Luo Jing

机构信息

Department of Ophthalmology, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Rd, Changsha, Hunan, 410011, People's Republic of China.

Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, 410011, People's Republic of China.

出版信息

BMC Ophthalmol. 2019 Jul 16;19(1):150. doi: 10.1186/s12886-019-1154-6.

Abstract

BACKGROUND

Morning glory syndrome is a relatively rare congenital optic disc anomaly that is often difficult to identify when associated with additional congenital ocular anomalies. This case report describes the diagnosis, treatment, and postoperative follow-up care of a young girl with morning glory syndrome accompanied by persistent fetal vasculature, retinal fold, and retinal detachment. Here, we also give a brief review of the relevant literature.

CASE PRESENTATION

A 5-year-old girl was referred to our clinic for a complaint of decreased vision for 6 months in the right eye. The best corrected visual acuity was hand motion in her right eye and 0.8 in her left eye. A fundus examination indicated vitreous opacities and scattered hemorrhages, as well as striped folds in the temporal retina of the affected eye. B-ultrasound and magnetic resonance imaging scans suggested that it could be a congenital dysplasia of the right eye. Pars plana vitrectomy was performed in the right eye. Morning glory syndrome associated with persistent fetal vasculature was confirmed in subsequent follow-up observation according to the fundus appearance, optical coherence tomography, and fundus fluorescein angiography imaging.

CONCLUSIONS

The patient was diagnosed as morning glory syndrome associated with persistent fetal vasculature and retinal fold. The morning glory disc with the presence of retinal folds did not seem quite typical and that made the diagnosis difficult. This report stresses the importance of considering concurrent morning glory syndrome and persistent fetal vasculature. Vitrectomy may be beneficial in the management of the morning glory syndrome and persistent fetal vasculature if accompanied by retinal detachment in similar cases.

摘要

背景

牵牛花综合征是一种相对罕见的先天性视盘异常,当与其他先天性眼部异常相关时,通常难以识别。本病例报告描述了一名患有牵牛花综合征并伴有永存原始玻璃体增生症、视网膜皱褶和视网膜脱离的年轻女孩的诊断、治疗及术后随访情况。在此,我们还对相关文献进行了简要综述。

病例介绍

一名5岁女孩因右眼视力下降6个月转诊至我院。其右眼最佳矫正视力为手动,左眼为0.8。眼底检查显示玻璃体混浊和散在出血,以及患眼颞侧视网膜的条纹状皱褶。B超和磁共振成像扫描提示可能为右眼先天性发育异常。右眼行玻璃体切割术。根据眼底表现、光学相干断层扫描和眼底荧光血管造影成像,在后续随访观察中确诊为牵牛花综合征合并永存原始玻璃体增生症。

结论

该患者被诊断为牵牛花综合征合并永存原始玻璃体增生症及视网膜皱褶。伴有视网膜皱褶的牵牛花视盘似乎不太典型,这使得诊断困难。本报告强调了考虑并发牵牛花综合征和永存原始玻璃体增生症的重要性。在类似病例中,如果伴有视网膜脱离,玻璃体切割术可能有助于治疗牵牛花综合征和永存原始玻璃体增生症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7347/6636068/2a4f7bb2077d/12886_2019_1154_Fig1_HTML.jpg

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