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惡性高血壓網膜、脈絡膜、視神經病變－病例報告
Hypertensive Retinopathy, Choroidopathy and Optic Neuropathy-A Case Report
摘要
惡性高血壓的眼底變化，同時發現有視網膜、脈絡膜、視神經病變的並不多見。本病例為一年輕病人，在突然視力模糊的主訴下，發現左眼底有廣泛性視網膜動脈變窄、火焰狀出血、棉絮滲出物、視網膜黃斑部水腫、Elschnig's spot、漿液性視網膜剝離、視神經乳頭水腫等，右眼則較輕微。病人血壓為200/120，合併有尿毒症，視力為右眼0.8，左眼0.2。經住院治療一星期後，視網膜黃斑部水腫漸消，黃斑部星形病灶開始出現，二星期後，網膜剝離消失。三星期後，Elschnig's spot消退呈現色素沉着現象。三個月後，雙眼視力恢復至1.0。
關鍵字
無資料並列摘要
Malignant hypertensive retinopathy is not rare, but the early stage of combined hypertensive retinopathy, choroidopathy and optic neuropathy is not commonly seen. We report a 21 years old women who complained of blurred vision in the Lt eye for 3 days. Ocluar examination disclosed splinter hemorrhages, cotton-wool spots, disc edema and some Elschnig's spots with serous retinal detachment in both eyes. Further biochemical & physical examination showed chronic renal insufficiency with secondary malignant hypertension. One week later, macular edema and serous detachment resolved progressively and macular star appeared. After 3 weeks, the previous RPE lesion sites of Elschnig's spot showed hyperpigmentation of RPE and the vision of the patient improved progressively under conservative treatment of blood pressure.
延伸閱讀
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