Banerjee Aparajita, Nayak Bhagabat, Verma Gargi, Parija Sucheta
Department of Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, India.
Department of Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, India
BMJ Case Rep. 2020 Feb 13;13(2):e231245. doi: 10.1136/bcr-2019-231245.
A 64-year-old hypertensive woman presented with complaints of a painless, progressive decrease in vision, headache, dizziness for the last month. She was a known case of diabetes mellitus on insulin therapy. On examination, best-corrected visual acuity was 6/12 in the right eye and 6/18 in the left eye. The fundus examination in both eyes revealed features of grade IV hypertensive retinopathy. Systemic examination revealed the raised blood pressure of 200/110 mm Hg. Diagnosis of pheochromocytoma was made on the basis of increased urinary norepinephrine (892.8 mg/dL) and mass in the left adrenal gland (measuring 31×28 mm) at contrast-enhanced CT. Medical management to control hypertension was done and ultimately, she underwent left laparoscopic adrenalectomy. After 10 months of surgery, the patient was asymptomatic, blood pressure was within normal limit and her vision improved to 6/6 in both the eyes. The retinal features of hypertensive retinopathy had completely disappeared.
一名64岁的高血压女性患者，主诉在过去一个月里出现无痛性、进行性视力下降、头痛和头晕。她是一名已知的糖尿病患者，正在接受胰岛素治疗。检查发现，右眼最佳矫正视力为6/12，左眼为6/18。双眼眼底检查显示为IV级高血压性视网膜病变。全身检查发现血压升高至200/110 mmHg。根据尿去甲肾上腺素升高（892.8 mg/dL）以及对比增强CT显示左肾上腺有肿块（大小为31×28 mm），诊断为嗜铬细胞瘤。采取了控制高血压的药物治疗，最终患者接受了左侧腹腔镜肾上腺切除术。术后10个月，患者无症状，血压在正常范围内，双眼视力提高到6/6。高血压性视网膜病变的眼底特征已完全消失。
