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玻璃体积血和视网膜新生血管形成继发于周边视网膜缺血,作为播散性黑色素瘤的表现。

Vitreous Haemorrhage and Retinal Neovascularization Secondary to Peripheral Retinal Ischemia as the Presenting Sign of a Disseminated Melanoma.

机构信息

Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.

Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.

出版信息

Ocul Immunol Inflamm. 2024 Jul;32(5):703-706. doi: 10.1080/09273948.2023.2198003. Epub 2023 Apr 18.

Abstract

PURPOSE

We describe a case of vitreous haemorrhage and retinal neovascularization secondary to peripheral retinal ischemia associated with disseminated melanoma.

METHODS

A retrospective case report.

RESULTS

A 48-year-old man presented with vitreous haemorrhage in the right eye, peripheral retinal ischemia, and retinal neovascularization in both eyes. CT and MRI scans were suggestive of disseminated malignancy and an ultrasound-guided biopsy of the abdominal mass confirmed metastatic melanoma. Immune checkpoint inhibitor therapy with ipilimumab/nivolumab was initiated. Regarding his ocular status, the vitreous haemorrhage cleared spontaneously, visual acuity improved to 6/7.5 and the patient underwent bilateral peripheral scatter laser photocoagulation to stabilize the retinopathy. The patient passed away 1 year after the initial presentation.

CONCLUSION

Our patient presented with melanoma and peripheral retinal ischaemia, leading to retinal neovascularization and vitreous haemorrhage. Therefore, melanoma should be considered as a differential diagnosis when investigating the aetiology of peripheral retinal ischaemia.

摘要

目的

我们描述了一例与弥漫性黑色素瘤相关的周边视网膜缺血引起的玻璃体出血和视网膜新生血管。

方法

回顾性病例报告。

结果

一名 48 岁男性因右眼玻璃体出血、周边视网膜缺血和双眼视网膜新生血管而就诊。CT 和 MRI 扫描提示为弥漫性恶性肿瘤,腹部肿块的超声引导活检证实为转移性黑色素瘤。开始使用免疫检查点抑制剂治疗(ipilimumab/nivolumab)。关于他的眼部状况,玻璃体出血自发清除,视力提高到 6/7.5,患者接受了双侧周边散射激光光凝治疗以稳定视网膜病变。患者在初次就诊 1 年后去世。

结论

我们的患者表现为黑色素瘤和周边视网膜缺血,导致视网膜新生血管和玻璃体出血。因此,当研究周边视网膜缺血的病因时,应将黑色素瘤作为鉴别诊断之一。

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