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1型神经纤维瘤病中的进行性虹膜睑裂部外翻和继发性闭角型青光眼。

Progressive ectropion uveae and secondary angle-closure glaucoma in type 1 neurofibromatosis.

作者信息

Esfandiari Hamed, Lasky Zeid Janice, Tanna Angelo P

机构信息

Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Division of Ophthalmology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.

出版信息

Am J Ophthalmol Case Rep. 2022 Feb 2;25:101345. doi: 10.1016/j.ajoc.2022.101345. eCollection 2022 Mar.

Abstract

PURPOSE

To present a case of progressive ectropion uveae and secondary angle-closure glaucoma in association with type 1 neurofibromatosis (NF-1).

OBSERVATION

An 11-year-old-Hispanic-male with a known history of NF-1 who was followed for the ocular manifestations of NF-1 developed an irregular pupil and ectropion uveae in the right eye at the age of 3 years that gradually increased in severity. The area of ectropion uveae increased in size and extended superiorly with concurrent superior synechial angle closure and intraocular pressure (IOP) elevation. The patient subsequently developed chronic angle-closure glaucoma that could not be controlled with medical therapy. He underwent successful implantation of an aqueous drainage device which resulted in excellent intraocular pressure reduction.

CONCLUSIONS AND IMPORTANCE

Ectropion uveae can be progressive and lead to the development of extensive angle closure in patients with NF-1. Despite the low incidence of glaucoma in patients with NF-1, the presence of ectropion uveae in this condition necessitates careful observation of the anterior segment, including the anterior chamber angle and close monitoring of the IOP.

摘要

目的

报告1例1型神经纤维瘤病(NF-1)相关的进行性葡萄膜外翻和继发性闭角型青光眼病例。

观察

一名11岁西班牙裔男性,有NF-1病史,因NF-1的眼部表现接受随访,3岁时右眼出现不规则瞳孔和葡萄膜外翻,且病情逐渐加重。葡萄膜外翻面积增大并向上扩展,同时伴有上方虹膜粘连性房角关闭和眼压升高。该患者随后发展为药物治疗无法控制的慢性闭角型青光眼。他成功植入了房水引流装置,眼压显著降低。

结论与意义

葡萄膜外翻在NF-1患者中可能呈进行性发展,并导致广泛的房角关闭。尽管NF-1患者青光眼发病率较低,但在此情况下出现葡萄膜外翻需要仔细观察眼前节,包括前房角,并密切监测眼压。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/445e/8829075/8eaa3ae4a599/gr1.jpg

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