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自发性出血性后弹力层脱离:影像学、诊断与治疗

Spontaneous hemorrhagic Descemet membrane detachment: Imaging, diagnosis, and management.

作者信息

Andersen Tomas, Barna Laura, Kanu Levi N

机构信息

Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.

出版信息

Am J Ophthalmol Case Rep. 2025 Apr 14;38:102337. doi: 10.1016/j.ajoc.2025.102337. eCollection 2025 Jun.

Abstract

PURPOSE

To describe unique features surrounding the etiology, diagnosis, and management of a rare presentation of hemorrhagic detachment of Descemet membrane.

OBSERVATIONS

A 91-year-old woman with chronic marginal corneal degeneration and corneal neovascularization of both eyes presented with hemorrhagic detachment of Descemet membrane of the right eye.

CONCLUSIONS AND IMPORTANCE

This case highlights the need to consider pre-Descemet hemorrhage on the differential diagnosis for anterior segment hemorrhage even in the absence of risk factors such as surgery and trauma. This case, initially thought to represent a hyphema, underscores the importance of anterior segment imaging in accurate diagnosis and monitoring of this condition. Lastly, this case illustrates a management approach that successfully cleared the hemorrhage, reattached Descemet membrane, and restored visual acuity without keratoplasty.

摘要

目的

描述Descemet膜出血性脱离这一罕见表现的病因、诊断及处理方面的独特特征。

观察结果

一名91岁患有双眼慢性边缘性角膜变性和角膜新生血管的女性,出现右眼Descemet膜出血性脱离。

结论及重要性

该病例强调,即使在没有手术和外伤等危险因素的情况下,对于前段出血的鉴别诊断也需要考虑Descemet膜前出血。该病例最初被认为是前房积血,强调了前段成像在准确诊断和监测这种情况中的重要性。最后,该病例说明了一种成功清除出血、使Descemet膜复位并在不进行角膜移植的情况下恢复视力的处理方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4426/12032173/322d0959cb40/gr1.jpg

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