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一名越南儿童出现伴有玻璃体出血并发症的脉络膜和视网膜回旋性萎缩。

Gyrate atrophy of the choroid and retina with vitreous hemorrhage complication in a Vietnamese child.

作者信息

Minh-Phu Nguyen, Giang Nguyen Hanh, Ngan-Ha Nguyen, Thu Nguyen Huu Hong, Ha Nguyen Hai

机构信息

Department of Pediatric Ophthalmology, Vietnam National Eye Hospital, Hanoi, Vietnam.

Department of Ophthalmology, Hanoi Medical University, Hanoi, Vietnam.

出版信息

Oman J Ophthalmol. 2025 Jun 24;18(2):208-211. doi: 10.4103/ojo.ojo_247_24. eCollection 2025 May-Aug.

Abstract

Gyrate atrophy (GA) of the choroid and retina is a rare autosomal recessive inherited disease characterized by elevation of plasma ornithine levels due to deficiency of the mitochondrial enzyme resulting in progressive chorioretinal atrophy, nyctalopia, and possibly blindness. This report presents the case of a 7-year-old Vietnamese boy with no history of trauma and a complaint of sudden visual loss over the past 6 weeks. Fundus examination showed vitreous hemorrhage in the right eye and chorioretinal atrophy with hyperpigmented margins in the periphery retina of the left eye. Based on the high serum ornithine level and compound heterozygous mutations detected in the () gene of the patient, he was diagnosed with GA. The patient underwent a right eye vitrectomy and was supplemented with Vitamin B6 and an arginine-restricted diet. Four months after surgery, the patient's visual acuity was significantly improved, and there was no progression of chorioretinal atrophy or recurrent vitreous hemorrhage. GA is an extremely rare disease and difficult to diagnose, especially when accompanied by vitreous hemorrhage. Combining genetic tests with clinical examinations helped diagnose accurately, and prompt treatment could restore the patient's visual function.

摘要

脉络膜和视网膜的回旋状萎缩(GA)是一种罕见的常染色体隐性遗传性疾病,其特征是由于线粒体酶缺乏导致血浆鸟氨酸水平升高,进而引起进行性脉络膜视网膜萎缩、夜盲症,并可能导致失明。本报告介绍了一名7岁越南男孩的病例,该男孩无外伤史,在过去6周内出现突发视力丧失的症状。眼底检查显示右眼玻璃体积血,左眼周边视网膜脉络膜视网膜萎缩伴色素沉着边缘。根据患者血清鸟氨酸水平升高以及在()基因中检测到的复合杂合突变,他被诊断为GA。该患者接受了右眼玻璃体切除术,并补充了维生素B6和限制精氨酸饮食。术后四个月,患者视力明显改善,脉络膜视网膜萎缩未进展,也未出现复发性玻璃体积血。GA是一种极其罕见的疾病,难以诊断,尤其是伴有玻璃体积血时。将基因检测与临床检查相结合有助于准确诊断,及时治疗可恢复患者的视觉功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc9b/12258844/a06d0b359a36/OJO-18-208-g001.jpg

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