伴有先天性颈内动脉缺如的眼部缺血综合征
Ocular Ischemic Syndrome With Congenital Absence of Internal Carotid Artery.
作者信息
Elwood Kevin F, Taboada Jorge L, Wong Robert W
机构信息
Department of Ophthalmology, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
Department of Medical Education, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
出版信息
J Vitreoretin Dis. 2019 Oct 15;4(1):79-83. doi: 10.1177/2474126419866136. eCollection 2020 Jan-Feb.
PURPOSE
This article describes a case of ocular ischemic syndrome (OIS) in a patient with a congenitally absent left internal carotid artery (ICA).
METHODS
Retrospective case report with anterior-segment and fundus photography, fluorescein angiography (FA), and computerized tomography angiography (CT-A).
RESULTS
A 31-year-old-man was found to have neovascularization of the iris (NVI) and angle of the left eye. FA showed capillary nonperfusion in the temporal periphery. He required intravitreal bevacizumab and triamcinolone injections and 2 panretinal photocoagulation treatments for persistent rubeosis and cystoid macular edema. Transient right-eye vision loss prompted CT-A, revealing an absent left ICA. Three years following presentation, FA continued to show delayed arteriovenous flow suggestive of OIS. He has required intravitreal bevacizumab injections every 12 weeks for persistent NVI.
CONCLUSION
Congenitally absent left ICA with resultant cerebrovascular insufficiency is a rare cause of OIS, underscoring the pathophysiological principles of insufficient blood supply to the ophthalmic artery.
目的
本文描述了一例患有先天性左侧颈内动脉（ICA）缺如的患者发生眼部缺血综合征（OIS）的病例。
方法
采用回顾性病例报告，包括眼前段和眼底照相、荧光素血管造影（FA）以及计算机断层血管造影（CT-A）。
结果
一名31岁男性被发现左眼虹膜和房角出现新生血管。FA显示颞侧周边毛细血管无灌注。他因持续性虹膜红变和黄斑囊样水肿接受了玻璃体内注射贝伐单抗和曲安奈德以及2次全视网膜光凝治疗。短暂的右眼视力丧失促使进行CT-A检查，结果显示左侧ICA缺如。就诊三年后，FA仍显示动静脉血流延迟，提示存在OIS。由于持续性虹膜新生血管，他需要每12周进行一次玻璃体内注射贝伐单抗。
结论
先天性左侧ICA缺如导致脑血管供血不足是OIS的罕见原因，强调了眼动脉供血不足的病理生理原理。
Zotero 插件