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題名:CENTRAL RETINALARTERY OCCLUSION IN A YOUNG MALE: A CASE REPORT     (14點)
年輕男性的中央動脈阻塞個案報告
著者:Hsiao-Cheng Lin(林孝政) ;Jen-Hua Hsu(許人化) ;Ching-Yao Tsai(蔡景耀) ;Shiow-Wen Liou(劉秀雯)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:central retinal artery occlusion ; metabolic syndrome ; obesity
刊名:中華民國眼科醫學會雜誌
卷期:48卷4期(2009.12)
頁碼:533-539
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

目的:報告一罕見特殊病例,於年輕男性,發生 中心視網膜動脈阻塞症,後來確診為代謝症候群。 方法:病例報告。 結果:一名34 歲肥胖男子突然在眼無痛性視力 模糊最佳矯正視力右眼1.0 左眼僅剩眼前30 公分手 指數,沒有眼壓增加,雙眼眼前段檢查正常,經散瞳 後檢查視網膜發現左眼黃斑部顯現出「櫻桃紅斑J ' 網膜血管周邊有火焰狀出血,有綿絮狀斑於視神經周 邊,發現是左眼的中心視網膜動脈阻塞,經光學眼底 斷層掃描左眼,左眼黃斑部水腫。病患、接受心臟超音 波及頸動脈超音波檢查無明顯異常。血球沉降速率、c-反應蛋白、血小板數量、肝功能檢查大致正常,給 予抗凝血劑及抗高血壓藥物治療。病人符合一些圓際 機構包括世界衛生組織(WHO) 、歐洲膜島素阻抗研究 協會(EGIR)代謝症候群的診斷標準-高血壓、血脂異 常、血糖代謝異常、肥胖。病患左眼經過治療追蹤, 視力仍維持在眼前30 公分手指數。 結論:綜合各種中心視網膜動脈阻塞症的風險因 素,對於這年輕男性,可被解釋為代謝症候群所造 成,在文獻上甚少發現。雖然此病人中心視網膜動脈 阻塞症預後有限,但是全身系統性檢查以排除了威脅 生命的併發症仍是最重要的。
Purpose: To present an unusual case of acute retinal a叫ery occlusion in a young male patient subsequently diagnosed with metabolic syndrome. Method: A case repo凡 Results: A 34-year-old obese male presented with sudden onset of painless visual loss in his left eye. He denied any m叫or systemic diseases, except hypertension at first. On examination, his best-corrected visual acuity in the left eye was only counting fingers at 30 cm, and that in the right eye was 1.0. Anterior segment examination was unremarkable with respect to normal intraocular pressures. Fundal examination after papillary dilatation revealed a cherry-red spot in the left foveal area, flame-shaped hemorrhages from narrow retinal vessels, and “cotton-wool" spots around the optic disc. OCT revealed obvious macular edema of the left eye. The findings of cardiac examination and auscu 卜 tation of the carotid artery were unremarkable. Systemic anticoagulation and ocular antihypertensive therapies were administered on admission. Immediate blood tests were conducted, but the ESR, CRP, platelets counts were within normallimits and the results of liver function tests were normal. This patient met the criteria for the metabolic syndrome, as defined by m 叫or international bodies such as the WHO, European Group for the Study of Insulin Resistance (EGIR), the National Cholesterol Education program of the United States, and American Heart Association: The patient had the risk factors of hypertension, abnormal lipid profile, abnormal glucose metabolism, and obesity. Unfortunately, there was no improvement in the best-corrected visual acuity of the aftected eye, which remained at counting fingers during follow-up. Conclusion: Young persons presenting with central retinal a 內ery occlusion with multiple comorbidities should be evaluated for the metabolic syndrome. While the prognosis of central retinal artery occlusion is extremely guarded, a systemic workup to rule out life-threatening comorbidities is the cornerstone of management in such cases.


    

本卷期目次
中華民國眼科醫學會雜誌 48卷4期 (2009.12)
青光眼手術及最新發展/ 呂大文陳怡豪
青光眼藥物治療的現狀與趨勢/ 吳國揚
透視青光眼檢查之雙面觀/ 陳瑛瑛
非動脈炎前缺血性視神經病變(NA-AION)的治療新趨勢/ 蔡榮坤
頸動脈海綿竇瘻管的新治療發展/ 王安國
青光眼臨床試驗之臨床應用:高眼壓症治療臨床試驗及正常眼壓性青光眼臨床試驗/ 張雪麗郭雅慧
視覺路徑病變之診斷定位/ 王安國
視神經退化疾病的神經保護治療/ 蔡榮坤
青光眼視神經病變的鑑別診斷/ 王清泓
MULTIFOCAL LENSES/ Hui-Chun LaiKen-Kuo LinWei-Chieh ChiuChiun-Ho HouJiahn-Shing LeeHan-Chih Cheng
白內障手術前後角膜生物力學之比較/ 徐文錦曾佳慧何一滔林思源林素玲
PERIOCULAR INFLAMMATION ASSOCIATED WITH ALENDRONATE THERAPY: A CASE REPORT AND REVIEW/ Yu-Ying ChangYi-Chun ChenI-Chia LiangChun-Chang LinShun-Ling Lin
CENTRAL RETINALARTERY OCCLUSION IN A YOUNG MALE: A CASE REPORT/ Hsiao-Cheng LinJen-Hua HsuChing-Yao TsaiShiow-Wen Liou
RETINAL VASCULITIS FOLLOWING CORNEAL PENETRATING INJURY--A CASE REPORT/ Pei-Hsuan LinNan-Kai WangKuan-Jen ChenKeng-Kuo LinLung-Kun, Yeh
SPONTANEOUS SEPARATION OF ACUTE MACULAR PUCKER AFTER RETINAL PHOTOCOAGULATION FOR PERIPHERAL RETINAL DEGENERATION--DOCUMENTED BY OPTICAL COHERENCE TOMOGRAPHY/ Hsi-Kung KuoChun-Chia SuChih-Hsin ChenTien-En Huang
DELAYED ASPERGILLUS VERSICOLOR INFECTION AFTER LASER IN SITU KERATOMILEUSIS--A CASE REPORT/ Pei-Chen WuPei-Yin HsuehLi-Ju Lai
CHOROIDAL REACTIVE LYMPHOID HYPERPLASIA--A CASE REPORT/ Yan-Ting ChenSan-Ni Chen
SUCCESSFUL TRABECULECTOMY FOR CHILDHOOD GLAUCOMA ASSOCIATED WITH ATYPICAL STURGE-WEBER SYNDROME AND TURNER'S SYNDROME/ Hsin-Yu YaoDa-Wen LuYen-Shou ChouJiann-Tong Chen
CRYSTALLINE KERATOPATHY CAUSED BY ALOCASIA MACRORRHIZA RELATED TRAUMA/ Yi-Hao HoYi-Yu TsaiChun-Chi Chiang
MIDLINE FOREHEAD FLAP FOR COVERAGE OF EXPOSED EXENTERATED ORBITAL WALLAFTER RADIOTHERAPY/ Ning-Chia WangYueh-Ju TsaiFu-Rung YangLih Ma
PRIMARY USE OF PNEUMATIC RETINOPEXY IN MANAGING OF RETINAL DETACHMENT CAUSED BY OCULAR PERFORATION AFTER RETROBULBAR ANESTHESIA--CASE REPORT/ Chun-Ju LinChong-Bin TsaiJiunn-Feng HwangSan-Ni Chen
 
   
 
   

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