BILATERAL PURTSCHER-LIKE RETINOPATHY IN A PATIENT OF ADVANCED BREAST CANCER -- A CASE REPORT

在末期乳癌出現雙眼Purtscher-like視網病變－病例報告

薛維禎(Wei-Chen Hsueh) ； 鄭琪睿(Chi-Juei Jeng) ； 馮介凡(Chien-Fan Fong) ； 柯美蘭(Mei-Lan Ko)

《中華民國眼科醫學會雜誌》 55卷 (2016/12) Pp. 73-79

https://doi.org/10.30048/ACTASOS.201612_55.0012

摘要

Purpose: To present a case of bilateral Purtscher-like retinopathy in a woman of advanced breast cancer. Method: Case report. Result: A 40-year-old female patient with advanced recurrent breast cancer presented bilateral Purtscher-like retinopathy. The patient had none of associated ocular history, recent head or eye trauma, and systemic disease except breast cancer. She had undergone left modified radical mastectomy for breast cancer 8 years ago and right modified radical mastectomy with neoadjuvant therapy 2 years previously. However, progressive bilateral blurred vision had developed since 1 month ago. Her best corrected visual acuity was 0.7 in both eyes. Meanwhile, bilateral peri-papillary flame-shaped hemorrhage and cottonwool spots without macula involvement were identified through ophthalmic examination. Pancytopenia and cachexia were found during hospitalization. Conslusion: This report presents a case of Purtscher-like retinopathy in a patient of advanced breast cancer with pancytopenia and cachexia. Purtscherlike retinopathy with retinal hemorrhage might be discovered in patients with advanced breast cancer without previous trauma or pancreatitis.

關鍵字

blurred vision ； breast cancer ； Purtscher-like retinopathy ； retinal hemorrhage

並列摘要

本文報告一名40歲末期復發性乳癌女性個案表現之Purtscher-like視網膜病變。本病患無相關眼部疾患或外傷病史或乳癌以外內科病史。個案業已分別於八年及五年前接受左側乳房部份切除及三年前右側部份乳房切除合併化療治療。然而，病患於一個月前出現雙側視力模糊及眼漲感。最佳矯正視力雙眼為0.7，合併雙側視神經盤週邊火焰狀出血併棉絮狀沉積物。結論：相近表現之Purtscher's及Purtscher-like視網膜病變除了可以出現在頭部外傷、胸部擠壓或長骨損傷病患以外，嚴重性內科疾患-如末期復發性乳癌也應列入其鑑別診斷。