急性挫傷性視網膜色素壞死－兩病例報告

Acute Contussion Necrosis of the Retinal Pigment Epithelium - A Report of Two Cases

楊中美(Chung-May Yang) ； 許慧娟(Hwai-Chiaun Shue)

《慈濟醫學雜誌》 10卷3期 (1998/09) Pp. 253-257

摘要

急性挫傷性網膜色素壞死發生於眼鈍傷。受損傷部位主要在視網色素之上皮及視網膜外層。因外傷造成眼介質混濁及色素上皮萎縮出現很快，臨床上較少觀察到急性期變化。本篇報告兩病例年齡分別為14歲及22歲。外後均出現神經盤附近之局部視網膜泛白變化合併局部視網膜下積液。螢光眼底攝影可見早期之網膜下螢光滲漏。數日內迅速轉變成色素上皮萎縮。因未傷及黃斑部視力恢復均理想。直接之機械性傷害可能為較合理之致病機轉。

關鍵字

脈絡膜破裂 ； 急性挫傷性壞死 ； 視網膜色素上皮細胞

並列摘要

Acute contusion necrosis of the retinal pigment epithelium (RPE) can develop after blunt ocular injuries. Beside the RPE, the outer segment of the photoreceptor cell layer is also affected. The lesion may escape diagnosis because of associated damage and its quick progression to RPE atrophy. We present two young patients who had localized whitening of the retina with subretinal fluid adjacent to the optic disc after a blunt ocular injury. Fluorescein angiography revealed early fluorescein leakage under the affected retina. The lesion showed RPE atrophic change within a few days in both cases. The macula was not involved in either case and the vision remained good. The mechanism may have been related to the direct mechanical effects of the trauma rather than to vascular insufficiency.

並列關鍵字

choroidal rupture ； acute contussion necrosis ； retinal pigment epithelium