病例报告

三叉神经鞘瘤并发神经麻痹性角膜炎一例

Trigeminal schwannoma complicated with nerve paralysis keratitis: a case report

:360-363
 
该文报道一例中年男性患者,因“头痛伴左侧听力下降”就诊于我院神经外科,经影像学检查诊断为“左侧三叉神经鞘瘤”, 手术前实验室检查发现血象异常,经血液科会诊后诊断为多发性骨髓瘤IgDλ型,于化疗期间并发神经麻痹性角膜炎(neurotrophic keratitis,NK),可于角膜中央偏下方的上皮及前基质层见到类圆形的灰白色浑浊,呈胶冻样,经局部药物治疗后好转,但残留角膜基质白色浑浊。由于现阶段临床对NK尚欠缺充分认识,易延误诊治,并且本文报道的此例NK患者,因其有化疗病史且于治疗期间出现相关体征,易被误诊为化疗并发细菌性角膜炎,文章通过分析其角膜病变的特征及简单回顾NK的临床特征、鉴别诊断及治疗,以期临床早期识别及治疗此类患者,恢复角膜的光学特性,维持良好的视觉体验。
Tis article reports a case of a middle-aged male patient who visited the Department of Neurosurgery of our hospital due to headache and lef hearing loss. He was diagnosed with lef trigeminal schwannoma by imaging examination and abnormal blood routine before surgery. During chemotherapy and paralytic keratitis (neurotrophic keratitis, NK), can be seen in the lower part of the corneal center of the epithelium and the prestromal layer of round gray and white turbidities, jelly like, afer local drug treatment improved, but residual corneal stromal white turbidities. Due to the lack of full understanding of NK in clinic at the present stage, diagnosis and treatment is easy to be delayed. In addition, the NK patient reported in this paper was easily misdiagnosed as bacterial keratitis complicated by chemotherapy due to his history of chemotherapy and related signs during treatment. Tis paper analyzed the characteristics of keratopathy and briefy reviewed the clinical characteristics, diferential diagnosis and treatment of NK, in order to identify and treat these patients in early clinical stage, restore the optical characteristics of cornea and maintain good visual experience.
眼底内专栏

结核性脉络膜结节联合视网膜结节1例

A case report of choroidal tubercle complicated with intraretinal tubercle

:122-126
 
眼结核的表现形式多样,有时会被误诊漏诊。本病例为一年轻男性,以右眼视力突发下降为主诉就诊,眼部表现可见黄斑区脉络膜占位病灶及视网膜内小病灶,经γ-干扰素释放试验、胸部CT等检查,确诊为血型播散性肺结核,眼部诊断为结核性脉络膜结节联合视网膜结节,全身接受抗结核治疗后,眼部病灶消退。
Ocular tuberculosis encompasses a variety of clinical manifestations, which is easily misdiagnosed sometimes. In this article, a young male was admitted to our hospital with a chief complaint of sudden blurred vision in his right eye. His ocular examination detected a tiny mass in the choroid and a small lesion in the retina. After interferon-gamma release assay (IGRA) and chest CT scan, the patient was diagnosed with military tuberculosis. The ocular examination confirmed the diagnosis of choroidal tubercle complicated with intrarentinal tubercle, which were healed after systemic anti-tuberculosis therapy.
病例报告

无明显外伤史的脉络膜破裂:1例病例报道并文献复习

Choroidal rupture without obvious trauma: a case report and literature review

:443-448
 
脉络膜破裂大部分是由撞击引起的对冲伤,冲击力通过玻璃体传导眼底引起,因此一般脉络膜破裂会有比较明确的外伤或者钝挫伤病史。本文将报告1例16岁体校男生在无明显外伤史出现多发性脉络膜破裂伤,通过查阅文献发现有文献报道在隐匿性假性黄色瘤(pseudoxanthoma elasticum,PXE)疾病中可在无明显外伤或轻微外伤出现脉络膜破裂,并根据文献复习考虑本病例为隐匿性PXE可能。
Most of the choroidal rupture is mostly caused by impact injury, and the impact force is caused by the vitreous conduction through the fundus. Therefore, the choroidal rupture generally has a clear history of trauma or blunt trauma. This article will report a case of a 16-year-old boy in a sports school who developed multiple choroidal ruptures without obvious trauma history. Through literature review, it was found that choroidal rupture can occur without obvious or minor trauma in subtle pseudoxanthoma elasticum (PXE) disease, and based on literature review, this case was considered as a possibility of subtle PXE.
病例报告

咽旁间隙肿瘤切除术后并发霍纳综合征1例

Horner syndrome after surgical treatment of parapharyngeal space mass: A case report

:685-690
 
    霍纳综合征是一种由眼交感神经传出通路中任意部分中断所造成的临床综合征,常以上睑下垂、瞳孔缩小等眼部特征为主要临床表现,往往提示头、颈或胸部严重疾病或术后并发症的发生。现报告1例49岁的男性患者,曾在武汉市中心医院耳鼻喉科行右侧咽旁间隙肿物切除术,术后第1天出现右眼上睑下垂,瞳孔缩小,伴同侧面部无汗。术后随访半年,上述症状未见明显改善。右侧咽旁间隙肿物的病理结果证实为交感干神经鞘瘤,该病例临床较为罕见。
Horner syndrome is caused by damage of the oculosympathetic pathway. It is a common disorder characterized by ocular signs such as ptosis and miosis, and these signs usually indicate the occurrence of severe head, neck and chest diseases or surgical complications. We report a case of 49-year-old male patient who underwent parapharyngeal space tumor resection in the Department of otolaryngology. On postoperative day one, the patient presented right eyelid drooping, the right pupil constricted, and the absence of sweating on the right side of the face.  After six months of follow-up, the above signs still presented and showed no significant change. T??he pathological assessment of the resected parapharyngeal space tumor demonstrated that it is the sympathetic trunk schwannoma, which is relatively rare in clinical practice.
病例报告

混合型永存胚胎血管1例

Combined persistent fetal vasculature: A case report

:679-684
 
永存胚胎血管(persistent fetal vasculature,PFV),也称永存原始玻璃体增生症( persistent hyperplastic primary vitreous,PHPV),是一种先天性眼病,多发现于婴幼儿时期。因大多数患儿单眼发病、症状隐匿,且易被误诊为单纯的先天性白内障,常常延误手术治疗的最佳时机。因此,正确的诊断和适宜治疗方式的选择对于患儿视功能的预后尤为重要。本文报道了1例6岁6个月的男性患儿,诊断为混合型PFV,眼部特征表现为先天性白内障和黄斑区结构错位。
Persistent fetal vasculature (PFV), also known as persistent hyperplastic primary vitreous (PHPV), is a congenital ocular anomaly, which is common in infants and young children. Due to most children have unilateral occurrence, insidious symptoms and are easily misdiagnosed as simple congenital cataract, the optimum time for treatment is often delayed. Therefore, correct diagnosis and appropriate treatment are particularly significant for the prognosis of PFV children’s visual function. A male child aged 6 years and 6 months with a diagnosis of combined PFV is reported, whose ocular features were congenital cataract and structural dislocation of macula.
病例报告

自体脂肪填充术后致眼缺血综合征1例及眼底影像学特征

Ocular ischemia syndrome after autologous fat filling: a case report and fundus imaging features

:671-678
 
眼缺血综合征(ocular ischemia syndrome,OIS)是由一系列诱因引发的以慢性眼部低灌注为主要临床表现的眼部疾病。临床相对少见,但对视力的影响较大,其症状主要包括一过性黑朦、缺血性眼痛、永久性视力丧失等。近年来医疗美容行业逐步兴起,自体脂肪填充技术使用逐渐增多,其所引起的OIS不可忽视。本文分析1例自体脂肪填充患者术后致OIS病例,研究该类疾病眼底影像学特征。
Ocular ischemia syndrome (OIS), featuring as chronic ocular hypoperfusion, is an eye disease caused by a series of incentives. It is relatively rare in clinical practice, but has a great impact on vision. The symptoms of OIS mainly include transient amaurosis, ischemic eye pain, permanent vision loss, etc. In recent years, with the rise of the Aesthetic Medicine industry, the technology of autologous fat filling has been increasingly adopted. The OIS caused by the surgery of autologous fat filling is nonnegligible. In this paper, by means of analyzing a case that an autologous fat filling surgery resulted in the OIS, discusses features of fundus angiography of OIS.
病例报告

白内障术后早期囊袋阻滞综合征1例

Early capsular block syndrome after cataract surgery: A case report

:157-161
 
囊袋阻滞综合征(capsular block syndrome,CBS)是白内障手术较为罕见的并发症,可发生在白内障术中、术后早期及晚期。本文报道1例23岁的女性患者,为发生在白内障术后早期的CBS,因左眼激素性白内障而实施左眼白内障超声乳化联合后房型人工晶状体(intraocular lens,IOL)植入术,术后患者因屈光不正、后囊膜及IOL之间较宽间隙而诊断为CBS,行Nd:YAG激光后囊膜切开治疗后,患者视力恢复至正常,后囊膜及IOL贴合紧密,随访期间未出现黄斑水肿及视网膜脱离等并发症。
Capsular block syndrome (CBS), a fairly rare complication of phacoemulsification, can develop into one of the three following possible clinical scenarios: intraoperative, early postoperative, and late postoperative, depending primarily on the timing of its occurrence following surgery. This paper reported a patient who developed early capsular block syndrome. A 23-year-old patient complained of poor distant vision after undergoing phacoemulsification combined with intraocular lens (IOL) implantation because of steroid-induced cataract. Anterior segment examination confirmed the diagnosis of capsular block syndrome. Neodymium-doped yttrium aluminum garnet (Nd:YAG) laser posterior capsulotomy resulted in complete resolution of her symptoms. No complication happened during follow-up.
病例报告

先天性外眦肿物合并眼睑畸形2例

Congenital lateral canthus mass with eyelid deformity: 2 case reports

:72-75
 
临床上儿童外眦部肿物合并眼睑畸形及结膜肿物少见,需在切除眼睑、结膜肿物的同时,灵活处置眼睑整复。本文回顾2例就诊于北京儿童医院的先天性外眦肿物合并眼睑缺损的病例。术后病理示皮赘伴结膜皮样脂肪瘤。患儿眼睑肿物切除彻底,眼睑整复后外观满意。
Lateral canthus mass with eyelid deformity and conjunctival mass is rare in children. The eyelid reduction should be handled flexibly while the mass is removed. Two cases of congenital lateral canthus with eyelid coloboma were reviewed in Beijing Children’s Hospital. Postoperative pathology showed fibroepithelial polyp and conjunctival dermolipoma. The eyelid masses of the child were completely excised, and the appearance was satisfactory after eyelid reduction.
临床病例讨论

内源性念珠菌性眼内炎误诊1例

Misdiagnosis of endogenous Candida endophthalmitis: A case report

:51-53
 
临床上内源性真菌性眼内炎比较少见,其早期临床表现因类似于葡萄膜炎等常见眼病常常被误诊。武汉爱尔眼科医院汉口医院收治了1例49岁女性患者,首诊为葡萄膜炎,后前房穿刺送检确诊为内源性念珠菌性眼内炎。
Endogenous fungal endophthalmitis is easy to be misdiagnosed because it is quite rare and early clinical features resembling uveitis. A 48-year-old female patient was admitted to Wuhan Aier Eye Hospital Hankou Hospital, her first diagnosis was uveitis, and the posterior anterior chamber puncture was confirmed as endogenous Candida endophthalmitis.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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