糖尿病玻璃体切除术后经玻璃体和视网膜下纤维蛋白样反应
Transvitreal and subretinal fibrinoid reaction following diabetic vitrectomy.
作者信息
Nelson Andrew J, Mehta Neesurg S, Ochoa Jorge R, Luo Caesar, Moussa Kareem
机构信息
UC Davis Eye Center, University of California Davis, Sacramento, CA, USA.
Bay Area Retina Associates, Oakland, CA, USA.
出版信息
Am J Ophthalmol Case Rep. 2022 May 24;27:101594. doi: 10.1016/j.ajoc.2022.101594. eCollection 2022 Sep.
PURPOSE
To describe an unexpected and atypical transvitreal and subretinal fibrinoid reaction following vitrectomy for non-clearing vitreous hemorrhage due to proliferative diabetic retinopathy.
OBSERVATIONS
A 58-year-old woman with bilateral proliferative diabetic retinopathy and non-clearing vitreous hemorrhage underwent combined phacoemulsification, intraocular lens implantation and vitrectomy in the right eye. Two months later she underwent staged phacoemulsification with intraocular lens implantation followed by vitrectomy in the left eye. The early postoperative course of each eye was complicated by choroidal effusion and submacular fibrinoid material on optical coherence tomography. The left eye also developed transvitreal fibrinoid bands.
CONCLUSIONS AND IMPORTANCE
Subretinal fibrin accumulation is a rare complication of diabetic vitrectomy. Optical coherence tomography (OCT) in the early post-operative period may assist in the recognition of this complication.
目的
描述在因增殖性糖尿病视网膜病变导致玻璃体出血不吸收而进行玻璃体切除术后出现的意外且非典型的经玻璃体和视网膜下纤维蛋白样反应。
观察结果
一名患有双侧增殖性糖尿病视网膜病变且玻璃体出血不吸收的58岁女性，右眼接受了白内障超声乳化吸除术、人工晶状体植入术和玻璃体切除术联合治疗。两个月后，她左眼接受了分期白内障超声乳化吸除术联合人工晶状体植入术，随后进行了玻璃体切除术。每只眼术后早期均出现脉络膜积液，光学相干断层扫描显示黄斑下有纤维蛋白样物质。左眼还出现了经玻璃体的纤维蛋白样带。
结论及重要性
视网膜下纤维蛋白积聚是糖尿病玻璃体切除术后一种罕见的并发症。术后早期的光学相干断层扫描（OCT）可能有助于识别这种并发症。
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