Zokri Mohd Faizal, Othman Othmaliza
Ophthalmology, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS.
Cureus. 2024 May 17;16(5):e60520. doi: 10.7759/cureus.60520. eCollection 2024 May.
This case series discusses the presentation, etiologies, and management of retinal artery occlusions in three patients. The first case was diagnosed as right eye central retinal artery occlusion (CRAO) secondary to a hypercoagulable state as the patient had been newly diagnosed with chronic myeloid leukemia. The second case had right branch retinal artery occlusion (RAO) secondary to a thromboembolic event following a percutaneous transluminal coronary angioplasty procedure. The third case involved a right eye CRAO secondary to vasospastic syndrome. The first case had good visual recovery as the patient presented to us within four hours of the onset. In contrast, the second and third cases presented after seven to eight hours, resulting in poor visual recovery. Though several measures have been devised to reverse the occlusion, the final visual prognosis still depends on the degree of occlusion and the time of presentation, as late presentation is usually associated with irreversible visual loss. Detection of RAO may require a multidisciplinary team approach, and proper and timely management may reverse the ischemic state of the retina.
本病例系列讨论了三名患者视网膜动脉阻塞的表现、病因及治疗。首例患者因新诊断为慢性髓系白血病导致高凝状态，被诊断为右眼中央视网膜动脉阻塞（CRAO）。第二例患者在经皮腔内冠状动脉成形术后发生血栓栓塞事件，继发右眼视网膜分支动脉阻塞（RAO）。第三例患者继发于血管痉挛综合征，出现右眼CRAO。首例患者在发病后四小时内就诊，视力恢复良好。相比之下，第二例和第三例患者在发病七至八小时后就诊，导致视力恢复不佳。尽管已制定了多种措施来逆转阻塞，但最终的视觉预后仍取决于阻塞程度和就诊时间，因为就诊延迟通常会导致不可逆的视力丧失。RAO的检测可能需要多学科团队协作，适当及时的治疗可能会逆转视网膜的缺血状态。
