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一名43岁男性,有30年玻璃体内异物留存史,现因视网膜脱离就诊。

A 43-Year-Old Man with a 30-Year History of a Retained Glass Intraocular Foreign Body Presenting with Retinal Detachment.

作者信息

Zhou Jilin, Thakur Sahil, Qian Chaoxu

机构信息

Department of Ophthalmology, The Third People's Hospital of Changzhou, Changzhou, Jiangsu, China.

Department of Ophthalmology, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.

出版信息

Am J Case Rep. 2025 May 10;26:e947369. doi: 10.12659/AJCR.947369.

Abstract

BACKGROUND This report describes the case of a 43-year-old man with a 30-year history of a retained glass intraocular foreign body (IOFB) presenting with retinal detachment. CASE REPORT We describe this case using patient history, ocular examination, and imaging, including anterior segment photographs, fundus photographs, and B-scan ultrasonography. A 43-year-old man presented with retinal detachment in the right eye. Medical history revealed that the patient had suffered an explosive injury to the right eye 30 years ago, for which he underwent surgical repair at the time of the incident. However, a glass IOFB was left in the eye, either due to an oversight during the initial treatment or an intentional decision by the treating physician. On examination, indirect ophthalmoscopy revealed a half-disc-sized retinal hole at the 9 o'clock position in the peripheral retina, along with long-standing atrophic lesions extending from 12 to 2 o'clock. Temporal macular-involving retinal detachment extending from 6 to 11 o'clock was observed. B-scan ultrasonography confirmed the presence of the glass IOFB. The patient subsequently underwent surgical treatment, including pars plana vitrectomy, removal of the IOFB, retinal reattachment, photocoagulation, and silicone oil tamponade. CONCLUSIONS Patients with open globe injuries should be carefully evaluated with the presumption of an IOFB. IOFBs may remain asymptomatic for decades, underscoring the importance of regular follow-up for patients with retained IOFBs. If complications such as retinal detachment occur, they can be managed routinely.

摘要

背景 本报告描述了一名43岁男性患者的病例,该患者有30年玻璃体内眼内异物(IOFB)存留史,现出现视网膜脱离。病例报告 我们通过患者病史、眼部检查和影像学检查(包括眼前节照片、眼底照片和B超检查)来描述该病例。一名43岁男性因右眼视网膜脱离就诊。病史显示,患者30年前右眼遭受爆炸伤,受伤当时接受了手术修复。然而,由于初始治疗时的疏忽或主治医生的有意决定,眼内遗留了一块玻璃IOFB。检查时,间接检眼镜检查发现周边视网膜9点钟位置有一个半视盘大小的视网膜裂孔,同时还有从12点钟延伸至2点钟的长期萎缩性病变。观察到颞侧累及黄斑的视网膜脱离,范围从6点钟延伸至11点钟。B超检查证实了玻璃IOFB的存在。患者随后接受了手术治疗,包括玻璃体切除术、取出IOFB、视网膜复位、光凝治疗和硅油填充。结论 开放性眼球损伤患者应假定有IOFB并进行仔细评估。IOFB可能数十年无症状,这凸显了对存留IOFB患者进行定期随访的重要性。如果发生视网膜脱离等并发症,可以进行常规处理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b4c/12077246/6c2f3a0e78b0/amjcaserep-26-e947369-g001.jpg

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