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伴有持续性上皮缺损的新生血管性青光眼：病理生理学与手术解决方案

Neovascular Glaucoma With Persistent Epithelial Defect: Pathophysiology and Surgical Solutions.

作者信息

Sharma Anugya, Dubey Suneeta

机构信息

Department of Glaucoma, Dr. Shroff's Charity Eye Hospital, New Delhi, IND.

出版信息

Cureus. 2025 May 17;17(5):e84275. doi: 10.7759/cureus.84275. eCollection 2025 May.

DOI:10.7759/cureus.84275
PMID:40525065
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12168793/
Abstract

We report a unique case of a 55-year-old male diabetic patient who presented with uncontrolled neovascular glaucoma and drug-related surface toxicity, causing persistent epithelial defect in both eyes, and the distinctive management that followed. The successful management of the first eye with amniotic membrane grafting following trabeculectomy prompted a similar approach in the other eye with co-management of both conditions. This case highlights the importance of a tailored, comprehensive approach to such complicated cases.

摘要

我们报告了一例独特的病例，一名55岁的男性糖尿病患者，患有未得到控制的新生血管性青光眼以及与药物相关的表面毒性，导致双眼持续性上皮缺损，以及随后采取的独特治疗方法。第一只眼在小梁切除术后采用羊膜移植成功治疗，促使对另一只眼采取类似方法并同时治疗这两种病症。该病例凸显了针对此类复杂病例采取量身定制的综合治疗方法的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3aa/12168793/2554471d26bb/cureus-0017-00000084275-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3aa/12168793/d73ce03154a5/cureus-0017-00000084275-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3aa/12168793/68cdca92a195/cureus-0017-00000084275-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3aa/12168793/7fe65400e2f7/cureus-0017-00000084275-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3aa/12168793/d74905be9d9c/cureus-0017-00000084275-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3aa/12168793/691e1001313d/cureus-0017-00000084275-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3aa/12168793/2554471d26bb/cureus-0017-00000084275-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3aa/12168793/d73ce03154a5/cureus-0017-00000084275-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3aa/12168793/68cdca92a195/cureus-0017-00000084275-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3aa/12168793/7fe65400e2f7/cureus-0017-00000084275-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3aa/12168793/d74905be9d9c/cureus-0017-00000084275-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3aa/12168793/691e1001313d/cureus-0017-00000084275-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3aa/12168793/2554471d26bb/cureus-0017-00000084275-i06.jpg

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本文引用的文献

1
Neurotrophic keratopathy: General features and new therapies.神经营养性角膜病变：一般特征和新疗法。
Surv Ophthalmol. 2024 Sep-Oct;69(5):789-804. doi: 10.1016/j.survophthal.2024.04.004. Epub 2024 Apr 26.
2
Ocular surface disease: a known yet overlooked side effect of topical glaucoma therapy.眼表疾病：局部青光眼治疗一种已知但被忽视的副作用。
Front Toxicol. 2023 Jul 21;5:1067942. doi: 10.3389/ftox.2023.1067942. eCollection 2023.
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Trabeculectomy for neovascular glaucoma in proliferative diabetic retinopathy, central retinal vein occlusion, and ocular ischemic syndrome: Surgical outcomes and prognostic factors for failure.
增生性糖尿病视网膜病变、视网膜中央静脉阻塞和眼缺血综合征新生血管性青光眼的小梁切除术：手术结果和失败的预测因素。
Indian J Ophthalmol. 2021 Nov;69(11):3341-3348. doi: 10.4103/ijo.IJO_1516_21.
4
Neovascular glaucoma - A review.新生血管性青光眼——综述。
Indian J Ophthalmol. 2021 Mar;69(3):525-534. doi: 10.4103/ijo.IJO_1591_20.
5
Persistent Corneal Epithelial Defects: A Review Article.持续性角膜上皮缺损：一篇综述文章。
Med Hypothesis Discov Innov Ophthalmol. 2019 Fall;8(3):163-176.
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Iatrogenic limbal stem cell deficiency following drainage surgery for glaucoma.青光眼引流手术后医源性角膜缘干细胞缺乏。
Can J Ophthalmol. 2018 Dec;53(6):574-579. doi: 10.1016/j.jcjo.2018.01.037. Epub 2018 Apr 2.
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Ocular Surface Disease and Glaucoma Medications: A Clinical Approach.眼表疾病与青光眼用药：临床治疗方法
Eye Contact Lens. 2019 Jan;45(1):11-18. doi: 10.1097/ICL.0000000000000544.
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Glaucoma-associated corneal endothelial cell damage: A review.青光眼相关性角膜内皮细胞损伤：综述。
Surv Ophthalmol. 2018 Jul-Aug;63(4):500-506. doi: 10.1016/j.survophthal.2017.11.002. Epub 2017 Nov 14.
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Primary Open-Angle Glaucoma Preferred Practice Pattern(®) Guidelines.原发性开角型青光眼临床实践指南（®）。
Ophthalmology. 2016 Jan;123(1):P41-P111. doi: 10.1016/j.ophtha.2015.10.053. Epub 2015 Nov 12.
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Long-Term Outcomes and Prognostic Factors of Trabeculectomy following Intraocular Bevacizumab Injection for Neovascular Glaucoma.玻璃体内注射贝伐单抗治疗新生血管性青光眼后小梁切除术的长期疗效及预后因素
PLoS One. 2015 Aug 14;10(8):e0135766. doi: 10.1371/journal.pone.0135766. eCollection 2015.