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一名患有1型糖尿病的29岁初产妇并发子痫前期和视网膜分支动脉阻塞:病例报告

Pre-eclampsia and branch retinal artery occlusion in a 29-year-old primigravida with type 1 diabetes: A case report.

作者信息

ScB Katerina Tori, Wirostko William, Palatnik Anna, Klatt Timothy

机构信息

Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, WI, United States of America.

Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, United States of America.

出版信息

Case Rep Womens Health. 2024 Jul 25;43:e00643. doi: 10.1016/j.crwh.2024.e00643. eCollection 2024 Oct.

Abstract

Branch retinal artery occlusion is a rare cause of sudden vision loss. New-onset visual disturbances are considered a severe feature of preeclampsia and an indication for delivery regardless of gestational age. This report describes the management of a primigravida at 31 weeks of gestation, with multiple comorbidities, who presented with preeclampsia and a new dark spot in her vision. After extensive workup, her branch retinal artery occlusion was not attributable to her preexisting comorbidities nor an undiagnosed thrombophilia. Multidisciplinary collaboration and close observation enabled delay of delivery until 34 weeks of gestation without detriment and substantially mitigated the risks of preterm birth. Her visual defect was stable and permanent. This seems to be the first case in the literature to describe branch retinal artery occlusion diagnosed simultaneously with preeclampsia in the third trimester. Branch retinal artery occlusion may not be a severe feature of preeclampsia requiring delivery.

摘要

视网膜分支动脉阻塞是导致突然视力丧失的罕见原因。新发视觉障碍被认为是先兆子痫的严重特征,也是无论孕周如何都应分娩的指征。本报告描述了一名孕31周的初产妇的治疗情况,该产妇有多种合并症,出现了先兆子痫和新的视野黑点。经过广泛检查,她的视网膜分支动脉阻塞既不归因于其既往合并症,也不归因于未诊断出的血栓形成倾向。多学科协作和密切观察使得分娩延迟至孕34周,且未造成损害,并大幅降低了早产风险。她的视觉缺陷稳定且为永久性。这似乎是文献中首例描述在孕晚期同时诊断出视网膜分支动脉阻塞和先兆子痫的病例。视网膜分支动脉阻塞可能不是先兆子痫需要分娩的严重特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad7c/11345387/af0f43a3f339/gr1.jpg

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