玻璃体内注射阿柏西普治疗年龄相关性黄斑变性后非动脉炎性前部缺血性视神经病变。
NONARTERITIC ANTERIOR ISCHEMIC OPTIC NEUROPATHY AFTER INTRAVITREAL AFLIBERCEPT FOR AGE-RELATED MACULAR DEGENERATION.
机构信息
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
出版信息
Retin Cases Brief Rep. 2022 Sep 1;16(5):653-657. doi: 10.1097/ICB.0000000000001053.
PURPOSE
To report a case of nonarteritic anterior ischemic optic neuropathy (NAION) after intravitreal injection in a patient with a history of fellow-eye NAION.
METHODS
Observational case report.
RESULTS
An 82-year-old woman with a history of fellow eye NAION developed an inferior visual field defect 1 day after an intravitreal aflibercept injection for neovascular age-related macular degeneration. She was found to have optic disk edema and an inferior altitudinal defect, consistent with NAION. The mechanism may have involved compromised perfusion to the optic nerve head related to elevated intraocular pressure or vasoconstriction because of antivascular endothelial growth factor activity.
CONCLUSION
Nonarteritic anterior ischemic optic neuropathy is a rare complication of intravitreal injection and may be related to postinjection elevation in intraocular pressure. Monitoring of intraocular pressure postinjection with low-threshold for preinjection aqueous suppression or postinjection anterior chamber paracentesis for persistently elevated intraocular pressure is recommended in patients with a history of NAION.
目的
报告一例既往发生对侧眼非动脉炎性前部缺血性视神经病变（NAION）的患者，在接受玻璃体内注射后出现该病。
方法
观察性病例报告。
结果
一名 82 岁女性，既往有对侧眼 NAION 病史，在因年龄相关性黄斑变性新生血管而接受玻璃体内注射阿柏西普后 1 天出现下视野缺损。她被发现存在视盘水肿和下垂直缺损，符合 NAION 的表现。发病机制可能与眼压升高或血管收缩导致视神经头部灌注受损有关，这可能与抗血管内皮生长因子活性有关。
结论
非动脉炎性前部缺血性视神经病变是玻璃体内注射的罕见并发症，可能与注射后眼压升高有关。对于有 NAION 病史的患者，建议在注射后监测眼压，对于眼压持续升高者，可考虑行前房穿刺术以降低眼压。
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