- 期刊
Complicated Cataract: An Unusual Manifestation of Hypoparathyroidism
併發性白內障：副甲狀腺功能低下症之罕見表現
摘要
一位年齡29歲女性，由於最近六個月來雙眼視力模糊前來求診，最佳矯正視力僅為零點二。患者有甲狀腺腫大合併甲狀腺功能亢進的七年病史，於1998年5月接受大部分甲狀腺切除術。手術之後，患者發生過數次手部肌肉筋孿，於1998年9月至內科求診，經詳細檢查後，診斷為手術後副甲狀腺功能低下症合併低血鈣，並開始使用口服鈣離子補充劑，但是血中鈣離子快速恢復正常，治療在六個月內就停止了。病患也未再繼續門診追蹤。由於患者最近六個月發生雙眼視力模糊，於2000年3月前來眼科門診求診，眼部檢查除了有雙眼白內障形成外，其他皆為正常，生化檢查則呈現低血鈣。推論雙眼併發性白內障形成與續發的低血鈣有密切關係。由於復發性副甲狀腺功能低下症雖未有臨床症狀，但是併發性白內障卻不知不覺加重而造成患者的雙眼視力模糊。經過成功的白內障手術後，患者的視力恢復良好。我們觀察到這一少見的個案以併發性白內障為臨床無明顯症狀之復發性後天永久性副甲狀腺功能低下症之最初表現。我們認為這個案例是值得詳細報告。
並列摘要
Background and Purpose: In March 2000, a 29-year-old female presented with a 6-month visual disturbance in both eyes. The binocular best-corrected visual acuity was only 6/30. In May 1998, subtotal thyroidectomy was performed for hyperthyroidism with thyroid goiter for seven years. However, postoperative hypoparathyroidism with tetany was noted. The patient was given an oral calcium supplement but this therapy was withdrawn within six months due to restoration of a normal serum calcium level. The patient was then lost to further follow-up. Methods: Ocular survey and systemic evaluation revealed no abnormal findings except for binocular cataract formation and low serum calcium. Complicated cataracts with mild sclerotic nucleus and a dense plaque-like opacity of the posterior subcapsular cortex were observed. Recurrent hypoparathyroidism was symptomless and accompanied with insidious and pronounced complicated cataract formation. Cataract surgery was performed. Results: The binocular best-corrected vision improved well after successful cataract surgeries. Conclusion: We observed a rare case of recurrent subclinical permanent acquired hypoparathyroidism presenting with binocular complicated cataract as the initial manifestation. We considered it appropriate to report the case in detail.