山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (4): 53-55.doi: 10.6040/j.issn.1673-3770.1.2020.055

• 眼缺血综合征多学科精准诊疗 临床研究 • 上一篇    下一篇

眼缺血综合征并发新生血管性青光眼一例并文献复习

秦书琪1,王露萍1,姜彬2,王艳玲1   

  1. 秦书琪1, 王露萍1, 姜彬2, 王艳玲1首都医科大学附属北京友谊医院, 1.眼科;
    2.神经内科, 北京 100050
  • 收稿日期:2020-05-31 出版日期:2020-07-20 发布日期:2020-08-28
  • 基金资助:
    首都卫生发展科研专项项目(首发2018-1-2021)

Neovascular glaucoma in ocular ischemic syndrome: a case report and literature reviewQIN Shuqi1, WANG Luping1, JIANG Bin2, WANG Yanling1 1. Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 10050, China; 2. Department of Neurology, Beijing Friendship Hospital, Capital Medical University, Beijing 10050, ChinaAbstract:

ObjectiveTo discuss the early diagnosis and multidisciplinary diagnosis and treatment of neovascular glaucoma in ocular ischemic syndrome. MethodsThe medical records of a 54-year-old male patient with cerebral infarction who presented with right-eye vision loss that had persisted for a week were reviewed. After slit-lamp examination and fluorescence angiography, he was diagnosed with ocular ischemic syndrome(OIS)complicated by neovascular glaucoma in the right eye and treated with intravitreal injection of anti-VEGF drugs and panretinal photocoagulation. ResultsAfter three months of treatment, the right-eye iris neovascularization subsided, and the intraocular pressure was controlled within normal limits. ConclusionOcular ischemia is often missed or misdiagnosed by ophthalmologists, neurologists, cardiologists, and vascular surgeons due to its insidious onset and complex clinical manifestations. Therefore, the establishment of multidisciplinary diagnosis and treatment can improve the prognosis of OIS patients.   

  1. Key words:Ocular ischemic syndrome;
    Neovascular glaucoma;
    Multidisciplinary diagnosis and treatment眼缺血综合征(ocular ischemic syndrome, OIS)是颈动脉狭窄或闭塞引起脑和眼供血不足, 从而产生一系列脑部和眼部症状的疾病［1］。OIS在临床上并不少见, 但是因其起病隐匿, 缺血程度不同, 使得眼部及全身表现复杂多样, 在临床上不易确诊, 常被眼科医生、神经科医生、心脏科医生、血管外科医生漏诊或误诊, 从而导致患者错过早期的治疗时机, 最终发展成不可逆的视力下降［2］。现将我科门诊接诊的一例右眼眼缺血综合征并发新生血管性青光眼患者的多学科诊疗过程与反思报告如下。
  • Received:2020-05-31 Online:2020-07-20 Published:2020-08-28

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摘要： 目的 探讨眼缺血综合征并发新生血管性青光眼的早期诊断及多学科治疗。 方法 回顾1例54岁男性脑梗患者的病例资料。主诉右眼视力下降1周就诊,经裂隙灯、眼底荧光血管造影及劲动脉超声等检查,诊断为右眼眼缺血综合征(OIS)并发新生血管性青光眼,行右眼玻璃体腔内注射抗VEGF药物及全视网膜光凝治疗。 结果 治疗3个月后右眼虹膜新生血管消退,眼压控制在正常范围内。 结论 眼缺血综合征的早期诊断及治疗是影响患者视力预后的关键因素,但因其起病隐匿,临床表现复杂多样,易被漏诊或误诊。因此建立多学科综合诊疗模式,有助于改善OIS患者的预后。

关键词: 眼缺血综合征, 新生血管性青光眼, 多学科综合诊疗

Abstract: Objective To discuss the early diagnosis and multidisciplinary diagnosis and treatment of neovascular glaucoma in ocular ischemic syndrome. Methods The medical records of a 54-year-old male patient with cerebral infarction who presented with right-eye vision loss that had persisted for a week were reviewed. After slit-lamp examination and fluorescence angiography, he was diagnosed with ocular ischemic syndrome(OIS)complicated by neovascular glaucoma in the right eye and treated with intravitreal injection of anti-VEGF drugs and panretinal photocoagulation. Results After three months of treatment, the right-eye iris neovascularization subsided, and the intraocular pressure was controlled within normal limits. Conclusion Ocular ischemia is often missed or misdiagnosed by ophthalmologists, neurologists, cardiologists, and vascular surgeons due to its insidious onset and complex clinical manifestations. Therefore, the establishment of multidisciplinary diagnosis and treatment can improve the prognosis of OIS patients.

Key words: Ocular ischemic syndrome, Neovascular glaucoma, Multidisciplinary diagnosis and treatment

中图分类号: 

  • R765.21
[1] 王艳玲. 眼缺血综合征的诊断与治疗[M]. 北京:人民军医出版社, 2012.
[2] Gologorsky D, Mohsenin A. Ocular Ischemic Syndrome. In: Medina C, Townsend J, Singh A. Manual of Retinal Diseases.
[3] Brown GC, Brown MM, Sharma S. The ocular ischemic syndrome[M] //Retinal and Choroidal Manifestations of Selected Systemic Diseases. New York, NY: Springer New York, 2012: 451-464.
[4] Jo YJ, Choi SK, Park SH, et al. Initial clinical manifestations of ocular ischemic syndrome in koreans[J]. J Korean Ophthalmol Soc, 2019, 60(12): 1231. doi:10.3341/jkos.2019.60.12.1231.
[5] 杨秀芬,李红阳,赵露,等. 眼缺血综合征的临床及影像学特点分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 119-123. doi: 10.6040/j.issn.1673-3770.0.2018.526. YANG Xiufen,LI Hongyang,ZHAO Lu,et al.Clinical and imaging characteristics in patients with ocular ischemic syndrome[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(4): 119-123. doi: 10.6040/j.issn.1673-3770.0.2018.526.
[6] Mendrinos E, Machinis TG, Pournaras CJ. Ocular ischemic syndrome[J]. Surv Ophthalmol, 2010, 55(1): 2-34. doi:10.1016/j.survophthal.2009.02.024.
[7] Mills RP. Anterior segment ischemia secondary to carotid occlusive disease[J]. J Clin Neuroophthalmol, 1989, 9(3): 200-204.[PubMed]
[8] 中华医学会眼科学分会青光眼学组. 中国新生血管性青光眼诊疗专家共识(2019年)[J]. 中华眼科杂志, 2019, 55(11):814-817. doi: 10.3760/cma.j.issn.0412-4081.2019.11.005.
[9] 王艳玲. 建立多学科综合诊疗模式,提高眼缺血综合征诊治水平[J]. 中华眼底病杂志, 2013, 29(3):233-236. doi: 10.3760/cma.j.issn.1005-1015.2013.03.001. WANG Yanling. Establishment of multidisciplinary diagnosis and treatment patterns for ocular ischemic syndrome[J].Chinese Journal of Ocular Fundus Diseases, 2013, 29(3):233-236. doi: 10.3760/cma.j.issn.1005-1015.2013.03.001.
[10] Lauria AL, Koelling EE, Houghtaling PM, et al. Carotid Endarterectomy for Ocular Ischemic Syndrome: A Case Report and Review of the Literature[J]. Ann Vasc Surg, 2020. doi: 10.1016/j.avsg.2020.03.005.
[11] 狄宇, 叶俊杰. 眼缺血综合征二例[J]. 中华眼科杂志, 2019, 55(6):454-457. doi: 10.3760/cma.j.issn.0412-4081.2019.06.009.
[12] 张子靖, 马翔. 颈动脉系统影像学检查在眼缺血综合征中的临床应用[J]. 眼科学报, 2018(2):113-117.doi:10.3978/j.issn.1000-4432.2018.05.02 ZHANG Zijing,MA Xiang.Clinical application of carotid artery system imaging examination in ocular ischemic syndrome[J].Eye Science,2018(2):113-117.doi:10.3978/j.issn.1000-4432.2018.05.02
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