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Neurology:血管炎相关视网膜中央动脉闭塞1例

2018-02-16 杨中华 脑血管病及重症文献导读

45岁,女性。既往皮肤狼疮,抗磷脂抗体阴性,平日预防性抗凝治疗。本次表现为左眼急性和严重无痛性视力丧失。

45岁,女性。

既往皮肤狼疮,抗磷脂抗体阴性,平日预防性抗凝治疗。

本次表现为左眼急性和严重无痛性视力丧失。

眼科检查诊断为视网膜中央动脉闭塞,眼底照相显示樱桃红点以及后极(posterior pole)弥漫性苍白:



高分辨增强MRI T1显示左侧眼动脉强化,血管壁增厚(白色箭头);右侧眼动脉正常(黑色箭头):



该患者未发现心脏、颈动脉栓子来源以及血管炎。给予抗血小板聚集(antiaggregant)药物治疗,无效。

以前有报道显示视网膜中央动脉闭塞在MRI DWI上表现为视乳头和视神经高信号,作者认为直接观察到动脉炎还是很少见的。

原始出处:
David Weisenburger-Lile, et al. Ophthalmic artery MRI in an arteritis-related central retinal artery occlusion. Neurology. 2018 Jan 23;90(4):188-189.doi:10.1212/WNL.0000000000004864.

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    2018-04-21 yinhl1978
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    2018-02-18 zutt

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