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硅油填充导致的毒性后段综合征继发术后视网膜血管阻塞:一例报告

Toxic posterior segment syndrome caused by silicone oil tamponade resulting in postsurgical retinal vascular occlusion: a case report.

作者信息

Kumoi Miho, Matsuda Satoshi, Matsumoto Mai, Tsujino Chieko, Otori Yasumasa

机构信息

Department of Ophthalmology, National Hospital Organization Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, Japan.

出版信息

Am J Ophthalmol Case Rep. 2025 Jul 28;39:102404. doi: 10.1016/j.ajoc.2025.102404. eCollection 2025 Sep.

Abstract

PURPOSE

We aimed to report a rare case of postoperative retinal vessel occlusion caused by silicone oil.

OBSERVATIONS

A 71-year-old male patient presented with decreased visual acuity and was diagnosed with macular hole retinal detachment (MHRD). The patient underwent pars plana vitrectomy (PPV) and was administered a silicone oil injection. The day after surgery, although inflammation and hyperemia within the anterior chamber were mild, fundus examination revealed evidence of retinal blood vessel occlusion. The patient was assumed to have contracted bacterial endophthalmitis and underwent PPV again, wherein the silicone oil was removed followed by antibiotic administration and steroid eye drops initiation. The inflammation improved 2 weeks after surgery; the patient underwent a second operation for MHRD and was administered a silicone oil injection. However, the same vascular occlusion findings were observed the day after surgery. Vascular occlusion was thought to be due to sterile inflammation rather than bacterial endophthalmitis; the inflammatory findings subsided after silicone oil removal.

CONCLUSIONS

In cases of retinal vascular occlusion occurring early after silicone oil injection, if the anterior segment inflammation is mild, the possibility of toxic posterior segment syndrome must be considered.

摘要

目的

我们旨在报告一例由硅油引起的术后视网膜血管阻塞的罕见病例。

观察结果

一名71岁男性患者出现视力下降,被诊断为黄斑裂孔性视网膜脱离(MHRD)。该患者接受了玻璃体切除术(PPV)并注射了硅油。术后第二天,尽管前房内的炎症和充血较轻,但眼底检查发现了视网膜血管阻塞的迹象。该患者被假定患有细菌性眼内炎,并再次接受了PPV,术中取出了硅油,随后给予抗生素并开始使用类固醇眼药水。术后2周炎症有所改善;该患者因MHRD接受了第二次手术并再次注射了硅油。然而,术后第二天观察到了相同的血管阻塞情况。血管阻塞被认为是由于无菌性炎症而非细菌性眼内炎;硅油取出后炎症表现消退。

结论

在硅油注射后早期发生视网膜血管阻塞的病例中,如果前段炎症较轻,必须考虑中毒性后段综合征的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ff5/12337693/6faa403bdca1/gr1.jpg

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