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新生儿弥散性血管内凝血的非典型眼部表现。

Atypical ophthalmic manifestations of disseminated intravascular coagulation in a newborn.

机构信息

Case Western Reserve University School of Medicine, Cleveland, Ohio.

University Hospitals Eye Institute, Rainbow Babies and Children's Hospital, Cleveland, Ohio.

出版信息

J AAPOS. 2020 Jun;24(3):181-183. doi: 10.1016/j.jaapos.2020.02.007. Epub 2020 Jun 3.

Abstract

Ophthalmic manifestations of disseminated intravascular coagulation (DIC) in a newborn are rare. Ocular involvement typically involves the posterior segment bilaterally and manifests as choroidal and/or retinal hemorrhages associated with fibrin thrombi in the choriocapillaris. We present the case of a newborn girl with DIC secondary to sepsis who subsequently developed nonclearing hyphema, related secondary cataract, 360° posterior synechiae, and nonclearing vitreous hemorrhage in the right eye and diffuse retinal hemorrhage in the left eye. The right fundus was not visible because of intraocular bleeding. The patient underwent cataract surgery at 39 days of life and was left aphakic. Two weeks later, she required subsequent vitrectomy because of a nonclearing vitreous hemorrhage. She developed amblyopia of the right eye and a right esotropia that required strabismus surgery. At 7 years of age, the patient's visual acuity was 20/50 in the right eye and 20/20 in the left eye.

摘要

新生儿弥散性血管内凝血(DIC)的眼部表现较为罕见。眼部受累通常累及双侧后节,表现为脉络膜和/或视网膜出血,伴有脉络膜毛细血管中的纤维蛋白血栓。我们报告了一例因败血症继发 DIC 的新生儿病例,随后右眼出现不消退性前房积血、相关的继发性白内障、360°后部粘连和不消退性玻璃体积血,左眼出现弥漫性视网膜出血。由于眼内出血,右眼眼底无法看清。患儿于生后 39 天行白内障手术,术后无晶状体。两周后,因玻璃体积血未吸收行玻璃体切割术。患儿右眼发生弱视,右眼内斜视,需要斜视手术。7 岁时,患儿右眼视力为 20/50,左眼视力为 20/20。

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