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題名 | Rapidly Resorptive Exudative Retinal Detachment in a Patient with Renogenic Hypertension: Case Report=快速吸收之滲出性視網膜剝離於一位腎因性高血壓病人之觀察:病例報告 |
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作者 | 廖旭彬; 楊克仁; 賴旗俊; 陳墩祿; 陳國書; | 書刊名 | 長庚醫學 |
卷期 | 22:2 1999.06[民88.06] |
頁次 | 頁324-327 |
分類號 | 416.746 |
關鍵詞 | 滲出性視視網膜剝離; 高血壓視網膜病變; 腎衰竭; Exudative retinal detachment; Hypertensive retinopathy; Renal failure; |
語文 | 英文(English) |
中文摘要 | 本文報告一位18歲女性因慢性腎衰竭合併腎因性高血壓而導至滲出性視網膜剝離 的案例。民國 87 年 7 月,病人主訴雙眼視力逐漸模糊已有 2 個月久,當時理學檢查,雙 眼眼底呈現一典型的高血壓視網膜病變。2 週後,病人因住院控制血壓而再度會診眼科;眼 底除高血壓視網膜病變外,尚發現顳側區域出現巨泡狀視網膜剝離。在積極的血壓控制及利 尿治療後,剝離網膜區域幾乎在2天內便迅速吸收,視力也在2週內逐漸進步。從本案例之臨 床觀察及治療效果看來,高血壓誘發滲出性視網膜剝離的致病機轉應為一多因子因素;良好 的血壓控制、適當的類固醇使用、以及水份電解質的平衡,對於腎衰竭病人而言是重要的並 可預防滲出性視網膜剝離的發生。 |
英文摘要 | We present an 18-year-old woman who developed rapidly resorptive exudative retinal detachment (ERD) due to chronic renal failure and renogenic hypertension. In July 1998, the patient came to our clinic because of a 2-month-history of progressively deteriorating visual acuity. Initially examination of the fundi revealed typical hypertensive retinopathy. Two weeks later, the patient was admitted due to hypertension and consulted our ophthalmic department again. In addition to hypertensive retinopathy, the fundi showed high bullous ERD, involving the temporal retinas in both eyes. Intensive medical therapy was begun, including blood pressure control and maintenance of body fluid and electrolyte balance, resulting in almost complete regression of retinal detachment within two days. The visual acuity improved during the following 2 weeks. The clinical features and treatment response in this rare case indicate that multiple factors, including fluids overload, hypertension, and possibly renal failure, contributed to the development of ERD. Blood pressure control and the balance of fluids are important in patients with renal failure, and may help to prevent the occurrence of ERD. |
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