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Purtscher氏视网膜病变

Purtscher氏视网膜病变
眼睛解剖构造
类型视网膜病变[*]
分类和外部资源
医学专科眼科
DiseasesDB33929
eMedicine1225431
[编辑此条目的维基数据]

Purtscher氏视网膜病变(Purtscher's retinopathy)是一种眼部(视网膜)受损的疾病。此病变通常与严重的头部外伤有关,但也可能与其他类型的创伤(例如骨折)或者多种非创伤的系统性疾病一起发生。然而,其确切的病因尚待厘清。目前还没有专门针对该病变的治疗方法,且预后也各有不同。此病变可能危害到视力,有时可导致暂时性或永久性的失明

该病以奥地利眼科医生Othmar Purtscher英语Othmar Purtscher(1852-1927)命名,他在1910年发现此病,并且在1912完整地描述该病变。

表现

相关疾病

病理生理学

Purtscher氏视网膜病变牵涉到复杂的病理生理机制、涉及多种促成因子,包含由以补体为中介所形成的聚合体、脂肪、空气、纤维蛋白凝块以及血小板团块。[1]这些情况可导致视网膜出现棉絮状斑点英语cotton wool spots(cotton wool spots,亦常见于许多其他疾病),以及视神经萎缩。[2]

诊断

当该病牵涉到创伤时,只有用来检查视网膜的眼底镜英语funduscopy是必要的诊断工具。[2]眼底萤光血管造影可能可显示出通往视网膜白区的血流量减少。

治疗

在某些情况下可以用去炎松治疗。 [3]但一般来说,目前还没有专门治疗Purtscher氏视网膜病变的方法。若该病由系统性疾病或栓塞引起,则应该去治疗这些疾患。

预后

Purtscher氏视网膜病变可导致视力受损,[4]且视力可能鲜少恢复。[2]但是在某些情况下,视力确实可能恢复;且关于该病长期的预后,有各种不同的记载。[5]

历史

起初,Purtscher氏视网膜病变在1910与1912年被描述为一种头部创伤后突然失明的症候群[6]伴随着双眼视网膜出现出血斑点以及变白的现象。[2]后来发现,该病也会发生在其他形式的创伤之后(例如胸部创伤),并且与其他多种非创伤的系统性疾病有关。Purtscher氏视网膜病变也可能与急性胰脏炎、血管炎、栓塞(如脂肪或羊水栓塞)、[7]全身红斑性狼疮、血栓性血小板减少性紫癜、以及慢性肾衰竭有关。该病变也可能由大范围的长骨骨折引起。[8]

参考文献

  1. ^ Buckley, Sally A.; James, B. Purtscher's retinopathy.. Postgraduate Medical Journal. July 1996, 72 (849): 409–12 [2012-12-02]. PMC 2398519可免费查阅. PMID 8935600. doi:10.1136/pgmj.72.849.409. (原始内容存档于2014-12-16). 
  2. ^ 2.0 2.1 2.2 2.3 Yanoff, Myron; Duker, Jay S. Ophthalmology 3rd. Edinburgh: Mosby. 2008: 750–754. ISBN 978-0323057516. 
  3. ^ Sub-Tenon's triamcinolone for post-partum Purtscher's-like retinopathy. Clinical Ophthalmology. March 2008, 2 (1): 195–8. PMC 2698687可免费查阅. PMID 19668404. doi:10.2147/opth.s2080. 
  4. ^ Purtscher's retinopathy: epidemiology, clinical features, and outcome. British Journal of Ophthalmology. Nov 2007, 91 (11): 1456–9. PMC 2095457可免费查阅. PMID 17556428. doi:10.1136/bjo.2007.117408. 
  5. ^ Schmidt, D; Otto, T. Prognosis and differential diagnosis of Purtscher's retinopathy. Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft. June 2004, 101 (6): 576–83. PMID 15197574. doi:10.1007/s00347-003-0952-6. 
  6. ^ Purtscher O. Angiopathia retinae traumatica. Lymphorrhagien des Augengrundes. Archives of Ophthalmology. 1912, 82 (2): 347–71 [2020-12-08]. doi:10.1007/bf01929449. (原始内容存档于2019-06-26). 
  7. ^ Retinopathy, Purtscher'seMedicine
  8. ^ Chuang, EL; Miller FS, 3rd; Kalina, RE. Retinal lesions following long bone fractures.. Ophthalmology. March 1985, 92 (3): 370–4. PMID 3991127. doi:10.1016/s0161-6420(85)34023-x. 

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