Chorich L J, Derick R J, Chambers R B, Cahill K V, Quartetti E J, Fry J A, Bush C A
Department of Ophthalmology, Ohio State University College of Medicine, Columbus, USA.
Ophthalmology. 1998 Mar;105(3):428-31. doi: 10.1016/S0161-6420(98)93023-8.
This study aimed to report three patients with hemorrhagic ocular and orbital complications associated with the use of systemic thrombolytic agents.
The study design was a retrospective small case series.
Three eyes of three patients were studied.
Surgical procedures to reduce intraocular pressure or relieve optic nerve compression were performed.
Visual acuity and intraocular pressure were measured.
Three patients received an intravenous thrombolytic agent on diagnosis of an acute myocardial infarction. One patient had a spontaneous suprachoroidal hemorrhage develop with secondary acute angle closure glaucoma shortly after receiving tissue plasminogen activator. Another patient had an orbital hemorrhage develop on receiving tissue plasminogen activator 4 days after an uncomplicated cataract extraction. The third patient experienced an orbital hemorrhage while receiving streptokinase 1 day after undergoing an external levator resection. Two patients suffered significant visual loss due to glaucoma or compressive optic neuropathy.
The onset of eye pain or visual loss after the administration of a systemic thrombolytic agent should alert the physician to the possibility of an ocular or adnexal hemorrhage. Prompt diagnosis and treatment can improve the likelihood of a favorable visual outcome.
本研究旨在报告3例与使用全身性溶栓药物相关的出血性眼及眼眶并发症患者。
研究设计为回顾性小病例系列。
对3例患者的3只眼进行了研究。
实施了降低眼压或缓解视神经压迫的手术。
测量视力和眼压。
3例患者在诊断为急性心肌梗死后接受了静脉溶栓药物治疗。1例患者在接受组织纤溶酶原激活剂后不久发生自发性脉络膜上腔出血，并继发急性闭角型青光眼。另1例患者在无并发症的白内障摘除术后4天接受组织纤溶酶原激活剂时发生眼眶出血。第3例患者在接受提上睑肌外路切除术后1天接受链激酶治疗时发生眼眶出血。2例患者因青光眼或压迫性视神经病变而出现严重视力丧失。
全身性溶栓药物给药后出现眼痛或视力丧失应提醒医生注意眼或附件出血的可能性。及时诊断和治疗可提高获得良好视力预后的可能性。
