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两例伴有视网膜脱离的鲁宾斯坦-泰比综合征

Two Cases of Rubinstein-Taybi Syndrome With Retinal Detachment.

作者信息

Kawaguchi Natsumi, Mano Fukutaro, Kondo Hiroyuki, Kuniyoshi Kazuki, Kusaka Shunij

机构信息

Department of Ophthalmology, Kindai University Hospital, Osakasayama, JPN.

Department of Ophthalmology, University of Occupational and Environmental Health, Kitakyushu, JPN.

出版信息

Cureus. 2025 Mar 4;17(3):e80048. doi: 10.7759/cureus.80048. eCollection 2025 Mar.

Abstract

We report two cases of Rubinstein-Taybi syndrome (RTS) with retinal detachment. Case 1 is a nine-year-old girl with RTS. She developed a macula-involving tractional retinal detachment (TRD) in the superior temporal quadrant of her right eye. Lens aspiration, intraocular lens implantation, vitrectomy with membrane peeling, and encircling were performed. However, retinal reattachment was not achieved. Two months after the surgery, neovascular glaucoma (NVG) in the right eye developed and consequently became phthisis bulbi two years after the surgery. At the age of 13 years, she underwent cataract surgery and vitrectomy for mature cataracts and worsening TRD in the left eye. Eleven months after surgery, NVG developed in the left eye, which was refractory to multiple glaucoma surgeries. In addition, the retina was re-detached and could not be reattached due to severe proliferative vitreoretinopathy. Case 2 is a 15-year-old boy with RTS, which was diagnosed immediately after birth. At the age of 10 years, total retinal detachment with a horseshoe tear occurred in the inferior temporal quadrant in the left eye, which underwent lensectomy, vitrectomy, and silicone oil tamponade. To achieve retinal reattachment, three vitrectomies were required. However, secondary angle-closure glaucoma developed one year after the last surgery. The intraocular pressure was poorly controlled even after trabeculotomy and goniosynechialysis, and his vision became no light perception three years postoperatively. Retinal detachment in patients with RTS may be challenging to treat, and multiple surgeries are required. Special caution is exercised regarding postoperative refractory glaucoma.

摘要

我们报告两例患有视网膜脱离的鲁宾斯坦-泰比综合征(RTS)病例。病例1是一名患有RTS的9岁女孩。她右眼颞上象限出现了累及黄斑的牵拉性视网膜脱离(TRD)。进行了晶状体抽吸、人工晶状体植入、玻璃体切除术联合膜剥除术以及环扎术。然而,视网膜未能复位。术后两个月,右眼发生新生血管性青光眼(NVG),术后两年右眼最终眼球萎缩。13岁时,她因左眼成熟白内障和TRD加重接受了白内障手术和玻璃体切除术。术后11个月,左眼发生NVG,对多次青光眼手术均无效。此外,视网膜再次脱离,由于严重的增殖性玻璃体视网膜病变无法再次复位。病例2是一名15岁患有RTS的男孩,出生后即被诊断。10岁时,左眼颞下象限出现伴有马蹄形裂孔的全视网膜脱离,接受了晶状体切除术、玻璃体切除术和硅油填充术。为实现视网膜复位,需要进行三次玻璃体切除术。然而,最后一次手术后一年出现了继发性闭角型青光眼。即使在小梁切开术和房角粘连分离术后,眼压仍控制不佳,术后三年他的视力丧失至无光感。RTS患者的视网膜脱离治疗可能具有挑战性,需要多次手术。术后难治性青光眼需格外谨慎处理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22d5/11879629/3c549082e728/cureus-0017-00000080048-i01.jpg

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