Hu He-He, Zhu Xiao-Yu, Xie Zheng-Gao, Chen Fang
Department of Ophthalmology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China.
Department of Ophthalmology, Xijing Hospital of the Air Force Medical University, Xi'an, China.
BMC Ophthalmol. 2020 Sep 22;20(1):374. doi: 10.1186/s12886-020-01634-3.
Spontaneous subretinal hemorrhage (SSRH) is a rare disease that severely affects the visual function, and is difficult to diagnose. This study aimed to describe the multimodality imaging characteristics of SSRH in a young male patient.
A 28-year-old male was presented to our hospital with "sudden drop of left eye vision for one week." Three weeks ago, he was admitted to other hospital due to sudden severe pain and unclear vision in the left eye for 1 h. The intraocular pressure was 69 mmHg, and the blood pressure was 230/120 mmHg. Skull CT and MRI detected abnormal signal shadows in the left eye and no abnormalities in the brain. B-ultrasonography indicated occupying lesions in the left eye. Two weeks later, the patient came to our hospital for treatment as the vision of the left eye had decreased sharply. Admission examination: blood pressure was 200/120 mmHg, best-corrected visual acuity was 20/20 in the right eye and hand motion in the left eye. Fundus details could not be evaluated in the left eye because of hemorrhage in the vitreous cavity. B-ultrasonography of the left eye revealed a dense, diffuse intravitreal hemorrhage. Skull MRI showed an abnormal signal shadow in the left eyeball, suggesting intraocular hemorrhage. Vitrectomy revealed a dome-shaped lesion in the peripheral part of the inferotemporal region during the operation. Postoperative indocyanine green angiography (ICGA) of the lesion showed hypofluorescence and no leakage or altered morphology during the whole imaging process. Follow-up showed gradual reabsorption of SSRH.
In this case, SSRH was considered to be associated with high blood pressure. Multimodal imaging provides accurate data for the diagnosis and follow-up of the disease.
自发性视网膜下出血(SSRH)是一种罕见疾病,严重影响视觉功能,且诊断困难。本研究旨在描述一名年轻男性患者SSRH的多模态影像学特征。
一名28岁男性因“左眼视力突然下降一周”就诊于我院。三周前,他因左眼突然剧烈疼痛且视力模糊1小时入住其他医院。眼压为69 mmHg,血压为230/120 mmHg。头颅CT和MRI检查发现左眼有异常信号影,脑部无异常。B超显示左眼有占位性病变。两周后,因左眼视力急剧下降,患者来我院治疗。入院检查:血压为200/120 mmHg,右眼最佳矫正视力为20/20,左眼手动。由于玻璃体腔出血,左眼眼底细节无法评估。左眼B超显示玻璃体腔内密集、弥漫性出血。头颅MRI显示左眼球有异常信号影,提示眼内出血。玻璃体切除术术中发现颞下周边部有一个穹窿状病变。术后病变的吲哚菁绿血管造影(ICGA)显示低荧光,整个成像过程中无渗漏或形态改变。随访显示SSRH逐渐吸收。
在本病例中,SSRH被认为与高血压有关。多模态成像为该病的诊断和随访提供了准确的数据。