一例 57 岁女性梅-赫格林异常患者行泪囊鼻腔吻合术后发生视神经病变的病例报告。
A case report of optic neuropathy following dacryocystorhinostomy in a 57-year-old female patient with May-Hegglin anomaly.
机构信息
Department of Ophthalmology, School of Medicine, Kosin University, #34 Amnam-dong. Seo-gu, Busan, 602-702, South Korea.
Department of Ophthalmology, College of Medicine, Gyeongsang National University, Gyeongsang National University Changwon Hospital, 121, Samjeongja-ro, Changwon, Gyeongsangnam-do, 51476, South Korea.
出版信息
BMC Ophthalmol. 2020 Apr 19;20(1):159. doi: 10.1186/s12886-020-01433-w.
BACKGROUND
We report a rare case of optic neuropathy following dacryocystorhinostomy (DCR) in a 57-year-old female patient with May-Hegglin anomaly.
CASE PRESENTATION
The patient was presented with sudden onset of vision loss for the left eye after DCR under general anesthesia. Her best corrected visual acuity was light perception in the left eye. Relative afferent pupillary defect was detected in her left eye. Magnetic resonance imaging of the orbit revealed an hyperintensity at the intra-orbital segment of the left optic nerve on T2-weighted image and Flair image. The patient was diagnosed with acute postoperative optic neuropathy and treated with methylprednisolone. Although her vision partially improved, she was left with a visual field defect in the left eye.
CONCLUSIONS
In patients with hematologic diseases, postoperative vision loss can occur following even minor surgery under general anesthesia, such as DCR. Therefore, preoperative counseling regarding the risk of visual loss should be given to high-risk patients.
背景
我们报告一例 57 岁女性梅-赫格林异常患者行泪囊鼻腔吻合术后发生视神经病变的罕见病例。
病例介绍
该患者于全身麻醉下行泪囊鼻腔吻合术后突发左眼视力丧失。她左眼最佳矫正视力为光感。左眼相对传入性瞳孔障碍。眼眶磁共振成像显示左眼眶内段视神经 T2 加权像和 Flair 像上呈高信号。患者被诊断为急性术后视神经病变，并接受甲基强的松龙治疗。尽管她的视力部分恢复，但左眼仍存在视野缺损。
结论
对于血液疾病患者，即使是全身麻醉下的小手术（如泪囊鼻腔吻合术）也可能导致术后视力丧失。因此，应向高危患者提供关于视力丧失风险的术前咨询。
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