疑頸部拔罐相關之中心視網膜動脈阻塞症

Central Retinal Artery Occlusion Following Neck Cupping

劉又綾(Yu-Ling Liu) ； 黃峻峰(Jiunn-Feng Hwang) ； 羅綸謙(Lun-Chien Lo) ； 陳珊霓(San-Ni Chen)

《中華民國眼科醫學會雜誌》 48卷2期 (2009/06) Pp. 223-227

https://doi.org/10.30048/ACTASOS.200906.0017

摘要

目的：報告一急性視力喪失，診斷為中心視網膜動脈阻塞症而視力恢復良好之病例。探討可能的致病原因以及影響視力預後之因素。
方法：病例報告。47歲男性病患於接受頸部拔罐治療後第二天主訴右眼視力喪失，最佳矯正視力僅存0.05，眼底檢查發現有視網膜變白，櫻桃紅斑、視網膜靜脈彎曲、以及視網膜出血。螢光血管攝影可見視網膜動脈灌注延遲出現、動靜脈通過時間過長現象，證實為中心視網膜動脈阻塞症。病患於接受治療後右眼視力恢復進步至1.0。
結論：頸部的拔罐治療是可疑的致病原因。而本病例的視力預後非常良好，推測有利復原的因素為：發病後能及時到院接受治療、血栓種類可能為較易自發溶解的凝血栓子、以及不完全阻塞型的中心視網膜動脈阻塞症。

並列摘要

Purpose: To present a case of central retinal artery occlusion (CRAO). The suspected etiology and factors of fair visual outcome were discussed.
Method: Observational case report.
Result: A 47-year-old male suffered from sudden vision loss of the right eye. He had a prior history of neck cupping one day earlier. On examination, best corrected visual acuity was 0.05 with a relative afferent pupillary defect of his right eye. Funduscopy revealed retinal opacification and a faint cherry-red spot consistent with a central retinal artery occlusion (CRAO). Fluorescein angiography demonstrated delayed retinal perfusion with markedly prolonged A-V transit time. Neither cilioretinal artery nor foveolar sparing was noted. Surprisingly, his visual acuity improved to 1.0 within one month and remained stable in the following 3 months.
Conclusion: The reasons visual recovery was excellent in this case of CRAO were thought to be early treatment and fibrin-platelet emboli as the causal emboli. We also point out the occult risk of neck cupping.

並列關鍵字

Central retinal artery occlusion CRAO ； Neck cupping ； Fibrin-platelet emboli