Kobayashi Takatoshi, Fukumoto Masanori, Takai Nanae, Maruyama Kohichi, Tada Rei, Shouda Hiromi, Kida Teruyo, Ikeda Tsunehiko
Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan.
Takai Eye Clinic, Kawachinagano-City, Japan.
Case Rep Ophthalmol. 2020 Mar 19;11(1):143-150. doi: 10.1159/000506436. eCollection 2020 Jan-Apr.
We experienced a case of subretinal hemorrhage (SRH) from choroidal neovascularization (CNV) complicating Vogt-Koyanagi-Harada disease (VKH) that underwent pneumatic displacement of hematoma by intravitreal gas injection. A 76-year-old male revealed VKH relapses and optical coherence tomography showed irregular retinal pigment epithelium in his right eye and serous retinal detachment and retinal pigment epithelial detachment in his left eye. Fluorescein angiography of the left eye showed hyperfluorescence possibly attributable to CNV. One month later, SRH occurred in the left eye, yet it was spontaneously absorbed. However, approximately 1 year later, the SRH recurred in the left eye affecting a wide area, including the macular region, and his visual acuity (VA) decreased to 0.06. When pneumatic displacement of the hematoma by intravitreal gas injection was performed, the SRH was inferiorly displaced, and his VA improved to 0.4. Pneumatic displacement with gas tamponade was effective for treating a case of SRH caused by persistent CNV complicating VKH.
我们遇到了一例脉络膜新生血管（CNV）合并Vogt-小柳-原田病（VKH）导致的视网膜下出血（SRH），通过玻璃体腔内注射气体进行了血肿的气体置换。一名76岁男性出现VKH复发，光学相干断层扫描显示其右眼视网膜色素上皮不规则，左眼浆液性视网膜脱离和视网膜色素上皮脱离。左眼荧光素血管造影显示可能归因于CNV的高荧光。1个月后，左眼发生SRH，但自行吸收。然而，大约1年后，左眼SRH复发，累及包括黄斑区在内的广泛区域，其视力（VA）降至0.06。当通过玻璃体腔内注射气体进行血肿的气体置换时，SRH向下移位，其视力提高到0.4。气体填塞的气体置换对于治疗由持续CNV合并VKH引起的SRH病例有效。
