Guimarães Bruno Figueira, Damásio Mariana Amaranto de Souza, Brina Luciana Ferreira, Figueiredo Gilberto Zulato Chaves, Houly Jacques Ramos
Hospital de Olhos Hilton Rocha, Belo Horizonte, MG.
Arq Bras Oftalmol. 2023 Oct 13;87(6):e20210269. doi: 10.5935/0004-2749.2021-0269. eCollection 2023.
This case report identified paracentral acute middle maculopathy as the cause of severe and irreversible vision loss after cataract surgery. Cataract surgeons should be aware of known risk factors for the development of paracentral acute middle maculopathy. In those patients, extra care regarding anesthesia, intraocular pressure, and some other aspects of cataract surgery must be taken. Paracentral acute middle maculopathy is currently understood as a clinical sign evident on spectral-domain optical coherence tomography, and it is probably evidence of deep ischemic insult to the retina. It should be a differential diagnosis in cases of marked low vision acuity associated with no fundus abnormalities in the immediate postoperative period, as demonstrated in the presented case.
本病例报告确定了黄斑中心凹旁急性中层病变是白内障手术后严重且不可逆视力丧失的原因。白内障手术医生应了解黄斑中心凹旁急性中层病变发生的已知危险因素。对于这些患者,在白内障手术的麻醉、眼压及其他一些方面必须格外小心。黄斑中心凹旁急性中层病变目前被认为是频域光学相干断层扫描上明显的临床体征,它可能是视网膜深层缺血性损伤的证据。如本病例所示,在术后即刻视力显著低下且眼底无异常的情况下,应将其作为鉴别诊断。