胸椎手术后双眼后部缺血性视神经病变1例并文献复习

doi:10.6040/j.issn.1673-3770.0.2023.211

摘要/Abstract

摘要： 目的报道1例胸椎手术后出现双眼后部缺血性视神经病变,提高眼科和脊柱外科医生对此病的认识。方法回顾性分析1例胸椎结核合并肾衰患者在胸椎手术后出现双眼后部缺血性视神经病变的临床资料并复习相关文献进行总结。结果全身及眼部予以改善循环、营养视神经及促进代谢药物治疗,辅以高压氧及针灸治疗。治疗3个月后右眼视力由0.15上升至0.2,左眼视力FC/1 m无变化。结论手术后视力丧失(postoperative visual loss, POVL)是与手术相关的永久性视力损害或完全失明,预后极差,脊柱科及眼科医生需提高对POVL的认知,尽量将POVL的发生率降至最低。

关键词: 视力丧失, 后部缺血性视神经病变, 胸椎术后, 胸椎结核, 肾衰

Abstract: Objective To report a case of binocular posterior ischemic optic neuropathy following thoracic vertebrae surgery, aiming to enhance the knowledge of ophthalmic and spinal surgeons. Methods The clinical data of posterior binocular ischemic optic neuropathy in a patient with thoracic tuberculosis complicated with renal failure after thoracic vertebra operation were retrospectively analyzed and the relevant literature was reviewed. Results Treatment involved medications to enhance circulation, nourish the optic nerve, and promote metabolism for the entire body and eyes. This was supplemented with hyperbaric oxygen therapy and acupuncture. After three months of treatment, the visual acuity of the right eye improved from 0.15 to 0.2, while the visual acuity in the left eye remained at FC/1 m. Conclusion Postoperative vision loss(POVL)is a severe and often permanent visual impairment associated with surgery, with a grim prognosis. Spinal and ophthalmic professionals should increase awareness of POVL and work to minimize its occurrence.

Key words: Vision loss, Posterior ischemic optic neuropathy, Postoperative thoracic vertebra, Tuberculosis of the thoracic vertebra, Renal failure

中图分类号:

R774.6

李姗姗,甘春兰,朱俊,华欣,陈放. 胸椎手术后双眼后部缺血性视神经病变1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 131-134.

LI Shanshan, GAN Chunlan, ZHU Jun, HUA Xin, CHEN Fang. Bilateral posterior ischemic optic neuropathy following thoracic vertebrae surgery: a case and literature review[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(4): 131-134.

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