A Case of Bilateral Branch Retinal Vein Occlusion after Medical Treatment for Lower Limb Cellulitis

藥物治療下肢蜂窩性組織炎後出現雙側性視網膜靜脈阻塞

王騰毅(Teng-Yi Wang) ； 陳喬鴻(Chiao-Hong Chen) ； 陳清龍(Ching-Long Chen) ； 陳建同(Jiang-Tong Chen) ； 呂大文(Da-Wen Lu)

《中華民國眼科醫學會雜誌》 45卷2期 (2006/06) Pp. 91-95

https://doi.org/10.30048/ACTASOS.200606.0004

摘要

目的：提出一名六十二歲男性於接受內科下肢蜂窩性組織炎治療後出現雙側性分支視網靜脈阻塞病例。
方法：病例回顧及文獻考查。
結果：一名六十二歲男性因兩週以來視力下降而前來求診，本身無其它系統性疾病。病人於一個月前因下肢蜂窩性組織炎接受Cloxacillin 250毫克一天四次的治療，為期一週。接著再接受Cephalexin 250毫克一天四次的治療，也是為期一週，至傷口癒合。此後病人開始感到視力模糊。兩週後來本院求診，眼部檢查發現右眼最佳矯正視力20/50，左眼最佳矯正視力20/70，而螢光血管攝影顯示右眼上顳側分支視網膜靜脈，及左眼下顯側分支視網膜靜脈阻塞。實驗室抽血檢查無血液凝固方面疾病。保守治療及門診追蹤五個月後雙眼最佳矯正視力回復到20/40。
結論：分支視網膜靜脈阻塞可能在以藥物治療下肢蜂窩性組織炎後出現。

並列摘要

Purpose: To describe a 62-year-old male developing bilateral branch retinal vein occlusion after medical treatment for lower limb cellulitis.
Methods: Retrospective review of medical chart and literature.
Results: A 62-year-old male without major systemic diseases presented with blurring of vision in both eyes. According to the patient's statement, he had medications prescribed for cellulitis on his left leg with varicose veins. He took Cloxacillin 250mg qid for one week, followed by Cephalexin 250mg qid for another week one month before the presentation. Physical examination revealed best-corrected visual acuity of 20/50 in the right eye and 20/70 in the left. Anterior segment examinations were unremarkable. Indirect ophthalmoscopy and fluorescein angiogram revealed occlusion of superiotemporal branch retinal vein in the right eye and inferiotemporal branch in the left. Laboratory studies showed no coagulatory abnormality. Slow resolution of the retinal hemorrhages and mild improvement of best-corrected visual acuity to 20/40 bilaterally were observed in five months.
Conclusions: Bilateral branch retinal vein occlusions may occur after medical treatment for cellulitis in the extremities with varicose veins.

並列關鍵字

branch retinal vein occlusion ； cloxacillin ； cephalexin ； varicose vein