Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung 80756, Taiwan.
Department of Ophthalmology, School of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
Int J Environ Res Public Health. 2022 Jun 30;19(13):8072. doi: 10.3390/ijerph19138072.
Ischemic retinopathy characterized by neovascularization could result from several diseases such as proliferative diabetic retinopathy, hypertensive retinopathy, and retinal vein occlusion. However, ocular ischemic conditions caused by polycythemia have rarely been described. We report the first case of polycythemia-related proliferative ischemic retinopathy in a 41-year-old male heavy smoker who had ocular ischemic condition due to secondary polycythemia. He had sudden loss of vision in his right eye vision with vitreous hemorrhage and a tortuous retinal artery. Tracing back to his history, he was a heavy smoker with more than one pack of cigarettes per day for more than 30 years. Laboratory data revealed elevated levels of hemoglobin (17.7 g/dL) and hematocrit (51.6%) without other abnormal findings. We performed retinal photocoagulation on the neovascular areas and the fibrous membrane. Additionally, the patient was advised to quit smoking. Owing to adherence to this treatment, the patient's vision gradually recovered. Although rare, polycythemia can cause retinal ischemic events and should be considered as a sight-threatening disease. Photocoagulation is effective on the regression of the neovascular lesion. Most importantly, changes in lifestyle together with smoking cessation are effective in managing secondary polycythemia. In conclusion, prevention and cessation of tobacco consumption helps improve vision health.
缺血性视网膜病变的特征是新生血管形成，可由多种疾病引起，如增生性糖尿病视网膜病变、高血压性视网膜病变和视网膜静脉阻塞。然而，由红细胞增多症引起的眼部缺血情况很少被描述。我们报告了首例与红细胞增多症相关的增生性缺血性视网膜病变，患者为一名 41 岁的男性重度吸烟者，由于继发红细胞增多症导致眼部缺血。他的右眼突然出现视力丧失，伴有玻璃体积血和视网膜动脉迂曲。追溯病史，他是一名重度吸烟者，每天吸烟超过一包，已有 30 多年。实验室数据显示血红蛋白（17.7g/dL）和血细胞比容（51.6%）升高，其他检查无异常发现。我们对新生血管区域和纤维膜进行了视网膜光凝治疗。此外，还建议患者戒烟。由于坚持这种治疗，患者的视力逐渐恢复。虽然罕见，但红细胞增多症可引起视网膜缺血事件，应视为一种威胁视力的疾病。光凝治疗对新生血管病变的消退有效。最重要的是，改变生活方式和戒烟对继发红细胞增多症的治疗有效。总之，预防和停止吸烟有助于改善视力健康。
