Feu-Basilio Silvia, Romero-Nuñez Barbara, Ventura-Abreu Néstor, Torras-Sanvicens Josep, Figueras-Roca Marc, Pazos Marta
Ophthalmology Institute, Hospital Clínic de Barcelona, Barcelona University (UB), Barcelona, Spain.
PhD Program, Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Department of Immunology, Ophthalmology and ORL, Faculty of Medicine, Complutense University of Madrid (UCM), Madrid, Spain.
Am J Ophthalmol Case Rep. 2022 Jan 22;25:101332. doi: 10.1016/j.ajoc.2022.101332. eCollection 2022 Mar.
To report a case of wound neovascularization (Swan syndrome) one year after trabeculectomy favorably treated with two intravitreal ranibizumab injections.
A 79-year-old woman under coumadin treatment for atrial fibrillation experienced relapsing decreased vision in her left eye due to vitreous hemorrhage. She had had a past history of ocular hypertension corneal decompensation after phacoemulsification that required a Descemet Membrane Endothelial Keratoplasty and a subsequent trabeculectomy. After clearance of the hemorrhage, examination showed neovascularization not in the retina but surrounding the sclerostomy wound of the trabeculectomy, being diagnosed as a Swan syndrome. After two intravitreal injections of ranibizumab, gonioscopy showed complete resolution of the new vessels. No further recurrences have been reported and IOP has remained controlled without glaucomatous changes 7 months after the last injection. Clinical features and patient characteristics are described.
Anti-vascular endothelial growth factor intravitreal injections may be a good and safe alternative to manage vitreous hemorrhage secondary to wound neovascularization of the trabeculectomy site.
报告一例小梁切除术后一年出现伤口新生血管形成（斯旺综合征）的病例，该病例经两次玻璃体内注射雷珠单抗得到有效治疗。
一名79岁因心房颤动接受华法林治疗的女性，因玻璃体出血导致左眼视力反复下降。她既往有眼压升高病史，白内障超声乳化术后角膜失代偿，需要进行Descemet膜内皮角膜移植术及随后的小梁切除术。出血清除后，检查发现新生血管并非在视网膜，而是围绕小梁切除术的巩膜造口伤口，诊断为斯旺综合征。两次玻璃体内注射雷珠单抗后，前房角镜检查显示新生血管完全消退。自最后一次注射后7个月，未见进一步复发，眼压保持稳定，无青光眼性改变。描述了临床特征和患者特点。
玻璃体内注射抗血管内皮生长因子可能是治疗小梁切除部位伤口新生血管形成继发玻璃体出血的一种安全有效的替代方法。
