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一名抗磷脂综合征患者白内障手术后发生视网膜分支动脉阻塞的病例。

A case of branch retinal artery occlusion postcataract surgery in an antiphospholipid syndrome patient.

作者信息

Bhatia Gagan, Kumar Sandeep, Shroff Daraius, Gupta Priyanka

机构信息

Shroff Eye Centre, New Delhi, India.

出版信息

Oman J Ophthalmol. 2023 Jun 27;16(2):351-354. doi: 10.4103/ojo.ojo_302_22. eCollection 2023 May-Aug.

Abstract

A 46-year-old female with preoperative vision 6/18 N18 (LogMar 0.5) in re and posterior subcapsular cataract underwent an uneventful phacoemulsification surgery under a peribulbar block. On the postoperative day 2, she complained of no visual gain in the operated eye. The reported vision was counting fingers close to the face. Through multimodal imaging (MMI), a diagnosis of branched retinal artery occlusion (BRAO) was made. A detailed consultation and history taking with the patient revealed a concealed history of four miscarriages in the past. A detailed systemic blood workup revealed antiphospholipid antibody (APLA) positive. BRAO postuneventful cataract surgery is a devasting outcome for the surgeon and patient undergoing surgery. The report focuses on the importance of taking detailed past medical history and usage of MMI early to rule out and diagnose unexpected scenarios. We suggest BRAO in our patient was a result of emboli formation, which is a common element in APLA-positive patients.

摘要

一名46岁女性,右眼术前视力为6/18 N18(LogMar 0.5),患有后囊下白内障,在球周阻滞麻醉下顺利接受了超声乳化手术。术后第2天,她主诉手术眼视力未提高。报告的视力为靠近面部数指。通过多模态成像(MMI),诊断为视网膜分支动脉阻塞(BRAO)。与患者进行详细的会诊和病史采集后发现,她过去有四次流产的隐匿病史。详细的全身血液检查显示抗磷脂抗体(APLA)呈阳性。白内障手术顺利后发生BRAO,对于外科医生和接受手术的患者来说都是灾难性的结果。本报告强调了详细询问既往病史以及早期使用MMI以排除和诊断意外情况的重要性。我们认为,我们这位患者的BRAO是栓子形成的结果,而栓子形成在APLA阳性患者中是一个常见因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c4d3/10433039/7ce0fdc481ff/OJO-16-351-g001.jpg

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