Mir Tahreem, Iftikhar Mustafa, Seidel Natalie, Trang Michelle, Goldberg Morton F, Woreta Fasika A
Department of Ophthalmology & Visual Science, Yale School of Medicine, New Haven, CT, USA.
Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Clin Ophthalmol. 2020 Dec 1;14:4165-4172. doi: 10.2147/OPTH.S281875. eCollection 2020.
To report the clinical characteristics, complications, and outcomes of hyphema in patients with sickle cell trait (SCT).
Retrospective case series.
Medical records of SCT patients (confirmed by hemoglobin electrophoresis) presenting with hyphema at the Wilmer Eye Institute over 10 years (January 2008 through December 2017) were reviewed in detail. Data were collected regarding etiology, demographics, clinical course and management. Main outcome measures included intraocular pressure (IOP) and visual acuity (VA).
A total of 14 black patients (males: 57%; median age: 20 years) were included in the study with a median follow-up of 4 months (range: 1 week to 6 years). Ten patients had traumatic hyphema with a mean presenting VA of approximately 1.10 logMAR (Snellen equivalent=20/250) and a mean presenting IOP of 40 mmHg. Nine of them required medical intervention to lower IOP, and six of them ultimately required surgical intervention, primarily in the form of anterior chamber paracentesis and/or washout. The mean time to achieve IOP control was 3 days, and the mean final VA was approximately 0.10 logMAR (Snellen Equivalent=20/25). Four patients had non-traumatic hyphema with a mean presenting VA of approximately 1.8 logMAR (Snellen equivalent=20/1260) and a mean presenting IOP of 31 mmHg. Three of them required medical intervention to lower IOP, and two of them ultimately required surgical intervention. Overall, seven patients underwent anterior chamber washout, six needed an anterior chamber paracentesis to lower the IOP, two required tube shunt placement procedures and one patient underwent a trabeculectomy. The mean time to achieve IOP control was 5 days, and the mean final VA was approximately 0.80 logMAR (Snellen equivalent=20/125).
Patients with SCT are likely to develop elevated IOP in the setting of hyphema, with a majority requiring one or more surgical interventions to achieve IOP control.
报告镰状细胞性状（SCT）患者前房积血的临床特征、并发症及转归。
回顾性病例系列研究。
详细回顾威尔默眼科研究所10年间（2008年1月至2017年12月）出现前房积血的SCT患者（经血红蛋白电泳确诊）的病历。收集有关病因、人口统计学、临床病程及治疗的资料。主要观察指标包括眼压（IOP）和视力（VA）。
本研究共纳入14例黑人患者（男性占57%；中位年龄20岁），中位随访时间为4个月（范围：1周至6年）。10例患者为外伤性前房积血，初始平均视力约为1.10 logMAR（Snellen视力表等效值=20/250），初始平均眼压为40 mmHg。其中9例需要药物治疗以降低眼压，6例最终需要手术治疗，主要形式为前房穿刺和/或冲洗。眼压控制的平均时间为3天，最终平均视力约为0.10 logMAR（Snellen视力表等效值=20/25）。4例患者为非外伤性前房积血，初始平均视力约为1.8 logMAR（Snellen视力表等效值=20/1260），初始平均眼压为31 mmHg。其中3例需要药物治疗以降低眼压，2例最终需要手术治疗。总体而言，7例患者接受了前房冲洗，6例需要前房穿刺以降低眼压，2例需要行引流管植入手术，1例患者接受了小梁切除术。眼压控制的平均时间为5天，最终平均视力约为0.80 logMAR（Snellen视力表等效值=20/125）。
SCT患者在前房积血时眼压可能升高，大多数患者需要一种或多种手术干预以控制眼压。
