Department of Ophthalmology, Queen Elizabeth Hospital Birmingham,University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
Department of Ophthalmology, Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS trust,Birmingham, UK, Birmingham, UK.
BMJ Case Rep. 2021 Feb 5;14(2):e239954. doi: 10.1136/bcr-2020-239954.
A 32-year-old doctor, who has a medical history of primary Raynaud's disease and previous scotomas, presented to eye clinic with sudden onset blurring of vision (infero-nasally) with no other associated symptoms. The patient had good visual acuity bilaterally (6/6) and no anterior chamber activity or conjunctival hyperaemia. Findings consistent with a nerve fibre layer infarct were noted in the right eye, with unremarkable examination of the left eye. Optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) images were obtained, which showed an area of capillary shut down in keeping with a nerve fibre layer lesion. Previous literature pertaining to similar symptoms is sparse with symptoms such as migraines, epilepsy and visual loss being stated. This case provides further evidence of Raynaud's associated retinal artery spasm, with complete resolution at 4 weeks. We also demonstrate the accessibility of OCT and more importantly OCTA for investigation of sudden onset visual deficit.
一位 32 岁的医生,既往有原发性雷诺病病史和先前的盲点,因突发视力模糊(鼻下方)就诊于眼科诊所,无其他相关症状。患者双眼视力均良好(6/6),无前房活动或结膜充血。右眼发现神经纤维层梗死的表现,左眼检查无异常。行光学相干断层扫描(OCT)和光学相干断层扫描血管造影(OCTA)检查,显示与神经纤维层病变一致的毛细血管关闭区域。既往类似症状的文献报道较少,症状包括偏头痛、癫痫和视力丧失等。本病例进一步证实了与雷诺病相关的视网膜动脉痉挛,4 周后完全缓解。我们还展示了 OCT 的可及性,更重要的是 OCTA 可用于检查突发性视力缺损。