微小病变型肾病综合征患者的视网膜脱离：病例报告及文献复习
Retinal detachments in a patient with minimal change nephrotic syndrome: Case report and review of the literature.
作者信息
Ye Chunjian, Qiu Miaohua, Zhong Yu, Chen Jiejian
机构信息
Department of Nephrology, The 900th Hospital of Joint Logistic Support Force, People's Liberation Army of China (PLA), Fuzhou, Fujian, China.
出版信息
Front Nephrol. 2023 Jan 18;2:1070792. doi: 10.3389/fneph.2022.1070792. eCollection 2022.
BACKGROUND
To report an unusual case of minimal change nephrotic syndrome with sudden bilateral retinal detachment.
CASE PRESENTATION
A 54-year-old woman with minimal change nephrotic syndrome presented with sudden-onset visual blurring in both eyes. Optical coherence tomography scans revealed macular schisis and extramacular intraretinal separation. A kidney biopsy confirmed the diagnosis of minimal change disease. Glucocorticoid therapy was quickly started. During remission, her vision was restored, with complete resolution of the subretinal fluid observed on optical coherence tomography.
CONCLUSIONS
In minimal change nephrotic syndrome, fluid accumulation in the retina layer may occur, and gravity-induced vitreous traction on the inferior retina may cause retinal detachment. Patients should be advised to avoid large swings of the head and neck, handstands, and other activities that may increase the risk of retinal detachment. The possibility of retinal detachment should be considered when blurred vision occurs.
背景
报告一例罕见的微小病变型肾病综合征合并双侧视网膜突然脱离的病例。
病例介绍
一名54岁患有微小病变型肾病综合征的女性突然出现双眼视力模糊。光学相干断层扫描显示黄斑劈裂和黄斑外视网膜内分离。肾活检确诊为微小病变病。迅速开始糖皮质激素治疗。在缓解期，她的视力恢复，光学相干断层扫描显示视网膜下液完全消退。
结论
在微小病变型肾病综合征中，视网膜层可能会出现积液，重力引起的玻璃体对视网膜下方的牵引可能导致视网膜脱离。应建议患者避免头部和颈部的大幅度摆动、倒立以及其他可能增加视网膜脱离风险的活动。当出现视力模糊时，应考虑视网膜脱离的可能性。
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