Lodato G, Affronti A, Mangiavillano C
J Fr Ophtalmol. 1986;9(6-7):431-3.
The authors present a case of acute amaurosis following a retrobulbar injection of anaesthetic. The patient was a mononephric subject in hemodialytic treatment receiving, therefore, a daily therapy by heparin. The ophthalmoscopic feature reveals a pale optic disk oedema, normal arteries and tortuous veins; the fluorescein angiography confirms the papillary oedema and the normal arterial fillings. The echographic picture shows an hematic collection through the nerve sheath. The authors analyze the main pathogenic hypothesis of the amaurosis which should be ascribed to an acute ischemia of the disk caused by the hematoma formed through the nerve sheath. The role of the general conditions of the patient, mononephric in hemodialytic treatment, is emphasized as a possible risk factor even for a retrobulbar injection.
作者报告了1例球后注射麻醉剂后发生急性黑矇的病例。该患者为单肾个体，正在接受血液透析治疗，因此每日接受肝素治疗。眼底镜检查特征显示视盘苍白水肿、动脉正常而静脉迂曲；荧光素血管造影证实了视盘水肿和动脉充盈正常。超声图像显示通过神经鞘有血液积聚。作者分析了黑矇的主要致病假说，认为其应归因于通过神经鞘形成的血肿导致视盘急性缺血。强调了患者的一般状况（正在接受血液透析治疗的单肾个体）作为即使是球后注射的一个可能危险因素的作用。
