Schwartz-Matsuo syndrome病例報告

Schwartz-Matsuo Syndrome-Case Report

江元弘(Yuan-Hung Chiang) ； 蔡武甫(Wu-Fu Tsai)

《中華民國眼科醫學會雜誌》 40卷2期 (2001/06) Pp. 198-203

https://doi.org/10.30048/ACTASOS.200106.0018

摘要

本文報告一個眼部外傷引起的裂孔性網膜剝離合併續發性隅角開放型青光眼的病例。一位二十五歲女性病人，主訴右眼視力模糊，畏光，視物變形持續一年。右眼眼壓高，被以葡萄膜炎治療，並接受青光眼眼壓控制，但症狀無改善，經詳細的眼底檢查發覺有網膜下纖維化及明顯網膜下沈積物和大範圍的扁平網膜剝離，網膜裂孔位於相當周邊的位置接近鋸齒緣，經過網膜復位手術後，眼壓得以控制，症狀也獲得改善。可以說是典型的Schwartz症候群。
我們提出這個病例，來討論其鑑別診斷及治療。主要因為本症候群的主訴，徵候，症狀很容易讓人忽略眼球後段的檢查，而忽略了網膜剝離的可能性。這個病例提醒我們，面對眼壓高的病人，除了隅角，視神經盤及視野的檢查外，眼底周邊網膜的檢查也很重要。尤其對於藥物控制不好，且有外傷的病史的病人，要仔細檢查是否有網膜裂孔及扁平的裂孔性網膜剝離，對於這類的病人，只要將剝離的網膜復位良好，其他如前房的反應及眼壓都能同時不需藥物的治療而痊癒，預後良好。

並列摘要

We present a case of traumatic rhegmatogenous retinal detachment combined with secondary open angle glaucoma. A 25 year-old female complained of blurred vision, photophobia and metamorphopsia for one year. The intraocular pressure was as high as 60 mmHg. In the past one year, she was diagnosed to have uveitis. Then antiglaucoma medicine and topical steroid was prescribed but the treatment was in vain. On history taking, she had suffered from blunt injury five years ago.
Under detailed fundus examination, a flat retinal detachment with significant subretinal fibrosis and a small retinal tear at peripheral retina were noted Gonioscopy showed open angle. After successful retina reattachment surgery (scleral buckle surgery), all the above symptoms improved and the intraocular pressure was within normal limit without any medication.
Having experienced this case, we concluded that Schwartz-Matsuo syndrome should be considered in differential diagnosis of any secondary glaucoma. This is particulary true for young adult patient with ocular trauma history.

並列關鍵字

Schwartz Matsuo Syndrome