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蔓状血管瘤合并黄斑部大动脉瘤破裂。

Racemose hemangioma complicated with macular macroaneurysm rupture.

作者信息

Yamauchi Kodai, Suzuki Yukihiko, Tanaka-Gonome Takayuki, Adachi Kobu, Maeda Natsuki, Nakazawa Mitsuru

机构信息

Department of Ophthalmology, Hirosaki University Graduate School of Medicine, 5 Zaifu, Hirosaki, Aomori, Japan.

出版信息

Am J Ophthalmol Case Rep. 2021 Mar 5;22:101053. doi: 10.1016/j.ajoc.2021.101053. eCollection 2021 Jun.

Abstract

PURPOSE

To describe a rare case of racemose hemangioma which developed spontaneous macular macroaneurysm (MA) rupture and vitreaous hemorrhage.

OBSERVATIONS

A 29-year-old healthy asian female visited our hospital and a racemose hemangioma was found in the left eye. At presentation, the best corrected visual acuity (BCVA) was 30/20 in her left eye. At 9 years after the first visit, MA-like lesion was noted in the macular area. After that, vitreous and subretinal hemorrhage appeared in the left eye. The patient underwent simultaneous vitrectomy and cataract surgery, but vitreous re-hemorrhage occurred two days after the operation. To avoid re-hemorrhage, silicone oil (SO) tamponade was added in the second vitrectomy. Two years after the second operation, SO was removed and postoperative BCVA in the left eye was 20/200 without re-bleeding in the vitreous.

CONCLUSIONS AND IMPORTANCE

Although retinal hemorrhages have been reported in the patients with a racemose hemangioma, in our case the macular MA rupture occurred at 9 years after the first visit. Congenital retinal arteriovenous anastomosis can show a change in vascular shape in some cases, thus it is important to observe carefully.

摘要

目的

描述一例罕见的蔓状血管瘤自发黄斑部大动脉瘤(MA)破裂并玻璃体积血的病例。

观察结果

一名29岁健康的亚洲女性前来我院就诊,左眼发现蔓状血管瘤。初诊时,其左眼最佳矫正视力(BCVA)为30/20。初诊9年后,黄斑区发现类似MA的病变。此后,左眼出现玻璃体积血和视网膜下出血。患者接受了玻璃体切除术和白内障摘除术,但术后两天发生了玻璃体再次出血。为避免再次出血,在第二次玻璃体切除术中加入了硅油(SO)填塞。第二次手术后两年,取出了SO,左眼术后BCVA为20/200,玻璃体未再次出血。

结论与意义

虽然已有蔓状血管瘤患者发生视网膜出血的报道,但在我们的病例中,黄斑部MA破裂发生在初诊9年后。先天性视网膜动静脉吻合在某些情况下可出现血管形态改变,因此仔细观察很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54d0/7994723/474f8391d2fe/gr1.jpg

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