Rego-Lorca Daniela, Burgos-Blasco Bárbara, Moreno-Morillo Francisco Javier, Valverde-Megías Alicia, Fernández-Vigo José Ignacio
Ophthalmology, Sant Pau Hospital, Barcelona, ESP.
Ophthalmology, Clinico San Carlos Hospital, Madrid, ESP.
Cureus. 2023 Jan 25;15(1):e34204. doi: 10.7759/cureus.34204. eCollection 2023 Jan.
Central retinal artery occlusion (CRAO) is a medical emergency, considered a stroke equivalent by the American Heart Association. There are a few reported cases of bilateral CRAO, most of them occurring in the context of a systemic predisposing condition. We present a case of bilateral CRAO following kidney transplantation. This 58-year-old man suffered CRAO in the right eye 24 hours after having kidney transplantation surgery. Treatment with an intravenous bolus of high-dose corticosteroids and full-dose anticoagulation therapy was initiated. However, 48 hours later, the patient suffered contralateral CRAO, resulting in irreversible bilateral amaurosis. CRAO is a rare but devastating complication of non-ophthalmological surgery and must be considered in postoperative patients with visual complaints. CRAO may have different causal mechanisms, but due to the similarity of their clinical manifestations, accurate etiology is not always easy to establish. Given the importance of an early diagnosis, all physicians should know about its risk factors and be aware of how patients with suspected CRAO must be rapidly referred for general and ophthalmological evaluation.
视网膜中央动脉阻塞（CRAO）是一种医疗急症，美国心脏协会将其视为等同于中风的病症。有少数双侧CRAO的病例报道，其中大多数发生在存在全身性易感因素的情况下。我们报告一例肾移植后发生双侧CRAO的病例。这名58岁男性在肾移植手术后24小时右眼发生CRAO。开始采用大剂量皮质类固醇静脉推注和全剂量抗凝治疗。然而，48小时后，患者对侧发生CRAO，导致不可逆的双侧失明。CRAO是非眼科手术中一种罕见但具有毁灭性的并发症，术后出现视力问题的患者必须考虑到这一点。CRAO可能有不同的病因机制，但由于其临床表现相似，准确的病因并不总是容易确定。鉴于早期诊断的重要性，所有医生都应了解其危险因素，并知晓疑似CRAO的患者必须如何迅速转诊以进行综合和眼科评估。
