Hyperviscosity Syndrome Associated with Branch Retinal Vein Occlusion-Case Report

黏性過大症導致之分枝網膜靜脈阻塞－病例報告

林純如(Chun-Ju Lin) ； 蔡忠斌(Chong-Bin Tsai) ； 陳彩雲(Tsai-Yun Chen) ； 譚超毅(Chau-Yi Tan) ； 張國彬(Kuo-Pin Chang)

《中華民國眼科醫學會雜誌》 41卷2期 (2002/06) Pp. 176-180

https://doi.org/10.30048/ACTASOS.200206.0014

摘要

黏性過大症是因為血液中細胞數目或蛋白質增加，或因細胞形態改變導致血液黏性上升的症候群。網膜靜脈血管阻塞是一種常見的網膜血管疾病，特別好發於中老年人。主要的危險因子為年齡，高血壓，血管硬化，及糖尿病。視力喪失通常是因為黃斑部出血，水腫，或滲出液。我們報告一位三十六歲男性病人因突然發生的右眼無痛視力模糊至本院求診，經內科診斷為黏性過大症引發之分枝網膜靜脈血管阻塞。施以治療性放血後，血比容顯著下降，並伴隨眼部疾患的改善。

並列摘要

Purpose: To report a case of hyperviscosity syndrome associated with branch retinal vein occlusion.
Method: Case report.
Results: A 36-year-old man complained of a sudden onset of painless, blurred vision CD. Best-corrected vision was 20/100 CD and 20/20 OS. Fundus examination and fluorescein angiography revealed branch retinal vein occlusion CD. On the second day, he was sent to the emergency department due to headache, malaise, and hand numbness. High blood pressure and hematocrit level (51.8%) were noted. Phlebotomy produced a marked decrease of the hematocrit. Best-corrected vision improved to 20/25 OD. Fundus examination revealed only residual retinal hemorrhage after 1 week. Hypertension associated relative polycythemia and hyperviscosity syndrome was diagnosed by the hematologist. Best-corrected vision was 20/12 CD after one year and the fundus showed no sequela.
Conclusion: For young patients presenting as sudden painless loss of vision, the possibility of hyperviscosity syndrome should be ruled out. Proper and timely management may restore the patients’ vision and avoid systemic complications.

並列關鍵字

Hyperviscosity syndrome ； branch retinal vein occlusion ； seconddary polycythemia ； phlebotomy