Dohlman Thomas H, Shah Neepa, Prensky Colin, Gupta Mrinali P, D'Amico Donald J, Kiss Szilard, Sales Christopher S
Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA.
Am J Ophthalmol Case Rep. 2020 Feb 1;17:100610. doi: 10.1016/j.ajoc.2020.100610. eCollection 2020 Mar.
To describe a case of bilateral, sequential placoid choroidopathy following uncomplicated Descemet's membrane endothelial keratoplasty (DMEK).
A 49-year old woman presented with flashing lights and central visual field scotomas after undergoing uncomplicated DMEK combined with cataract surgery for Fuch's endothelial dystrophy in the right eye. She was found to have placoid choroidopathy responsive to systemic steroids and for which a comprehensive work-up was unrevealing. Three and a half months later, she underwent DMEK surgery in the fellow eye and again developed placoid choroidopathy in the operated eye. Work-up was again unrevealing and the lesion followed a similar course to the first eye on systemic steroids. Over the course of seven (right eye) and three and a half months (left eye) of follow-up, the uncorrected visual acuity was 20/20 bilaterally and the retinal lesions had modestly improved.
We report a case of placoid choroidopathy following uncomplicated DMEK combined with cataract surgery in both eyes of a single patient. This case expands upon the reported complications following DMEK surgery and suggests a need to remain aware of posterior segment complications following endothelial keratoplasty.
描述一例在单纯性Descemet膜内皮角膜移植术(DMEK)后发生的双侧、相继性盘状脉络膜病变。
一名49岁女性在右眼因富克斯内皮营养不良接受单纯性DMEK联合白内障手术后出现闪光和中心视野暗点。她被发现患有对全身用类固醇有反应的盘状脉络膜病变,对此进行的全面检查未发现异常。三个半月后,她在对侧眼接受了DMEK手术,术眼再次出现盘状脉络膜病变。检查再次未发现异常,且在全身用类固醇治疗下,病变的发展过程与第一只眼相似。在随访的7个月(右眼)和三个半月(左眼)期间,双眼未矫正视力均为20/20,视网膜病变有一定程度改善。
我们报告了一例单眼患者双眼在单纯性DMEK联合白内障手术后发生盘状脉络膜病变的病例。该病例扩展了DMEK手术后报告的并发症,并提示需要持续关注内皮角膜移植术后的后段并发症。