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威尔逊病患者孔源性视网膜脱离的管理挑战:一例报告及文献综述

Challenges in Management of Rhegmatogenous Retinal Detachment in a Patient With Wilson's Disease: A Case Report and Literature Review.

作者信息

Alkhuraimi Waleed M, Alqahtani Wijdan, Alqahtani Abdullah S

机构信息

Ophthalmology, King Abdullah Medical City, Mecca, SAU.

Ophthalmology, King Khalid University, Abha, SAU.

出版信息

Cureus. 2021 Jan 26;13(1):e12921. doi: 10.7759/cureus.12921.

Abstract

Wilson's disease (WD) is a rare hepatolenticular inherited disorder affecting copper transport resulting in accumulation of copper, which leads to the induction of apoptosis in different organs. Furthermore, patients with WD have elevated cytokines activity responsible for inflammation of various tissues. Here, we report our challenges in managing a case of rhegmatogenous retinal detachment (RRD) in a one-eyed 28-year-old male with WD who had a previous history of severe intraocular inflammation that ended with phthisis bulbi after pars plana vitrectomy for RRD. After one year, he developed RRD in the seeing eye. A decision was made to perform scleral buckling to avoid the risk of postoperative intraocular inflammation. However, a barrage laser was required for shallow retinal detachment in a subsequent follow-up, which was ultimately complicated by severe intraocular inflammation. We observed that our patient with WD had a tendency for severe intraocular inflammation, even following minor non-surgical ophthalmic procedures. For this reason, ophthalmologists need to be aware of managing similar cases and perhaps other diseases associated with elevated levels of cytokines.

摘要

威尔逊病(WD)是一种罕见的肝豆状核变性遗传性疾病,影响铜转运,导致铜蓄积,进而引发不同器官的细胞凋亡。此外,WD患者的细胞因子活性升高,会引发各种组织的炎症。在此,我们报告在管理一名28岁独眼男性WD患者的孔源性视网膜脱离(RRD)病例时所面临的挑战,该患者既往有严重眼内炎症病史,在因RRD行玻璃体切割术后眼球萎缩。一年后,他的健眼发生了RRD。决定进行巩膜扣带术以避免术后眼内炎症风险。然而,在随后的随访中,对于浅视网膜脱离需要进行激光光凝,最终因严重眼内炎症而复杂化。我们观察到,即使是轻微的非手术眼科操作后,我们的WD患者也有发生严重眼内炎症的倾向。因此,眼科医生需要意识到如何管理类似病例以及或许与细胞因子水平升高相关的其他疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c49/7906275/e53bae73cdb5/cureus-0013-00000012921-i01.jpg

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