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一例上腔静脉综合征背景下的静脉超负荷性脉络膜病变。

A case of venous overload choroidopathy in the setting of superior vena cava syndrome.

作者信息

Marin Alejandro Itzam, Petrash Carson C, Jolly Austin, Gange William S, Mathias Marc T

机构信息

Department of Ophthalmology, University of Colorado Denver School of Medicine, Aurora, CO, USA.

出版信息

Am J Ophthalmol Case Rep. 2023 Aug 24;32:101918. doi: 10.1016/j.ajoc.2023.101918. eCollection 2023 Dec.

Abstract

PURPOSE

To report a case of overload venous choroidopathy in a patient with superior vena cava syndrome.

OBSERVATIONS

A patient presented with episcleral vessel dilation, bilateral subretinal fluid accumulations in the maculae and unilateral serous choroidal detachment. He had a medical history of kidney transplantation and was on chronic corticosteroids. Separately he had also experienced recurrent bilateral innominate vein occlusion and superior vena cava stenosis, consistent with a diagnosis of superior vena cava syndrome. His presentation was further complicated by a retinal vein occlusion in the left eye which was treated with anti-vascular endothelial growth factor intravitreal injections. The bilateral subretinal fluid accumulations responded well to photodynamic therapy.

CONCLUSIONS AND IMPORTANCE

We report a constellation of findings including venous overload choroidopathy and retinal vein occlusion as ocular manifestations of superior vena cava syndrome. The pathophysiologic changes leading to these findings could aid in the understanding of these related conditions.

摘要

目的

报告1例上腔静脉综合征患者发生的超负荷性静脉脉络膜病变。

观察结果

1例患者出现巩膜表层血管扩张、双侧黄斑区视网膜下液积聚以及单侧浆液性脉络膜脱离。他有肾移植病史,长期使用皮质类固醇。此外,他还曾反复出现双侧无名静脉闭塞和上腔静脉狭窄,符合上腔静脉综合征的诊断。他的病情因左眼视网膜静脉阻塞而更加复杂,该阻塞采用玻璃体内注射抗血管内皮生长因子进行治疗。双侧视网膜下液积聚对光动力疗法反应良好。

结论与意义

我们报告了一系列发现,包括静脉超负荷脉络膜病变和视网膜静脉阻塞,作为上腔静脉综合征的眼部表现。导致这些发现的病理生理变化有助于理解这些相关病症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76f1/10481172/df872aafc95b/gr1.jpg

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