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眶梗死综合征

Orbital infarction syndrome.

作者信息

Borruat F X, Bogousslavsky J, Uffer S, Klainguti G, Schatz N J

机构信息

Hôpital Ophtalmique Jules Gonin, University Eye Clinic, Lausanne, Switzerland.

出版信息

Ophthalmology. 1993 Apr;100(4):562-8. doi: 10.1016/s0161-6420(93)31606-4.

Abstract

BACKGROUND

The authors define orbital infarction as ischemia of all intraorbital and intraocular structures. It is a rare disorder due to the rich anastomotic vascularization of the orbit.

PATIENTS

The authors report three patients with orbital infarction with similar clinical presentations: acute blindness, orbital pain, total ophthalmoplegia, and anterior and posterior segment ischemia.

RESULTS

Etiologies of orbital infraction syndrome include occlusion of the common carotid artery (case 1), giant-cell arteritis (case 2), and mucormycosis (case 3).

CONCLUSION

Three cases discussed in this article illustrate that orbital infarction is a disorder that can occur secondary to different mechanisms such as (1) acute perfusion failure (e.g., common carotid artery occlusion [possibly combined with anomalous orbital anastomotic channels]), 2) systemic vasculitis (e.g., giant-cell arteritis), and (3) orbital cellulitis with vasculitis (mucormycosis). The blindness and retinal and optic nerve damage were permanent, whereas the other signs of orbital ischemia (ophthalmoplegia and anterior segment ischemia) resolved. Therefore, diagnosis of orbital infarction can best be made during the acute phase.

摘要

背景

作者将眼眶梗死定义为所有眶内及眼内结构的缺血。由于眼眶丰富的吻合血管化,这是一种罕见的病症。

患者

作者报告了三名眼眶梗死患者,临床表现相似:急性失明、眼眶疼痛、完全性眼肌麻痹以及眼前段和后段缺血。

结果

眼眶梗死综合征的病因包括颈总动脉闭塞(病例1)、巨细胞动脉炎(病例2)和毛霉菌病(病例3)。

结论

本文讨论的三个病例表明,眼眶梗死是一种可继发于不同机制的病症,如(1)急性灌注衰竭(如颈总动脉闭塞[可能合并异常眼眶吻合通道])、(2)系统性血管炎(如巨细胞动脉炎)和(3)伴有血管炎的眼眶蜂窝织炎(毛霉菌病)。失明以及视网膜和视神经损伤是永久性的,而眼眶缺血的其他体征(眼肌麻痹和眼前段缺血)得以缓解。因此,眼眶梗死的诊断最好在急性期进行。

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