Marshood Abdullah Al, Al Judaibi Ramzi, Alkhaldi Hamdah, Mura Marco
Ophthalmology Department, Qassim University, Qassim, Saudi Arabia.
Consultant Ophthalmologist, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Am J Ophthalmol Case Rep. 2022 Aug 5;27:101681. doi: 10.1016/j.ajoc.2022.101681. eCollection 2022 Sep.
To describe the management and outcome of a patient with oculocutaneous albinism and complicated proliferative diabetic retinopathy, as well as to discuss treatment challenges and strategies in this patient population.
A 52-year-old patient with oculocutaneous albinism and diabetes presented with light perception vision in her right eye and 20/300 vision in her left eye. Examination showed a diabetic tractional retinal detachment in the right eye and high-risk proliferative diabetic retinopathy (PDR) in the left eye. In the right eye, the patient underwent pars plana vitrectomy, membrane delamination, endolaser therapy, and silicone oil tamponade, with follow-up evaluations showing a flat retina under silicone oil with regressed retinopathy in this eye. In her left eye, pan-retinal photocoagulation was attempted without success, with persistent PDR and absence of laser marks in this eye. Subsequently, the patient underwent six intravitreal anti-VEGF injections, after which she developed a tractional retinal detachment necessitating treatment cessation and a planned surgical intervention.
This case highlights the difficulty of using standard medical and surgical treatment strategies when caring for patients with oculocutaneous albinism and complicated proliferative diabetic retinopathy. If medical treatments fail in these patients, surgical approaches should be planned with extreme care due to the risks and challenges posed by hypopigmented fundi.
Interventional case report.
描述一名患有眼皮肤白化病和复杂性增殖性糖尿病视网膜病变患者的治疗及预后情况，并探讨该患者群体的治疗挑战和策略。
一名52岁患有眼皮肤白化病和糖尿病的患者，右眼仅有光感视力，左眼视力为20/300。检查发现右眼存在糖尿病性牵拉性视网膜脱离，左眼有高危增殖性糖尿病视网膜病变（PDR）。右眼患者接受了玻璃体切割术、膜分层术、视网膜激光光凝治疗及硅油填充，随访评估显示硅油填充下视网膜平复，该眼视网膜病变消退。左眼尝试进行全视网膜光凝治疗但未成功，左眼仍存在持续性PDR且无激光斑。随后，该患者接受了6次玻璃体内抗VEGF注射，之后出现牵拉性视网膜脱离，不得不停止治疗并计划进行手术干预。
该病例凸显了在照顾患有眼皮肤白化病和复杂性增殖性糖尿病视网膜病变的患者时，使用标准药物和手术治疗策略的困难。如果这些患者的药物治疗失败，由于色素减退性眼底带来的风险和挑战，手术方案的制定应格外谨慎。
介入性病例报告。
