PDF(Pubmed)
Abstract：
BACKGROUND: Intraocular inflammation is common after anterior or posterior segment surgery. They typically manifest either as non-infectious inflammation of the anterior or posterior segment, known as toxic anterior or posterior segment syndrome (TPSS), or as sterile or infective endophthalmitis. In this report, we describe a rare case of TPSS following vitreoretinal surgery, presenting as hemorrhagic retinal vasculitis.
METHODS: A 58-year-old male diagnosed with a left eye acute rhegmatogenous retinal detachment underwent an uneventful primary pars plana vitrectomy with silicone oil endotamponade on the same day of presentation. At presentation, there were no signs of intraocular inflammation, and his visual acuity in the affected eye was 20/200.
RESULTS: The retina was well-attached with silicone oil in place on the first post-operative day. Along the inferior retinal periphery, a hemorrhagic occlusive vasculitis was observed. Clinical examination revealed retained intraocular cotton fiber along the inferotemporal quadrant over the retinal surface. In addition to the standard post-operative medications, a course of systemic steroids (40 mg per day of Prednisolone tablets) was started. At the end of the first post-operative week, clinical signs of hemorrhagic retinal vasculitis were beginning to resolve, and by the end of the fourth post-operative week, they had completely resolved.
CONCLUSIONS: This report describes an unusual diagnosis of TPSS after vitreoretinal surgery, most likely due to the presence of an intraocular cotton fiber. This excessive inflammation of the posterior segment usually responds to a course of topical and systemic steroids.
METHODS: A 58-year-old male diagnosed with a left eye acute rhegmatogenous retinal detachment underwent an uneventful primary pars plana vitrectomy with silicone oil endotamponade on the same day of presentation. At presentation, there were no signs of intraocular inflammation, and his visual acuity in the affected eye was 20/200.
RESULTS: The retina was well-attached with silicone oil in place on the first post-operative day. Along the inferior retinal periphery, a hemorrhagic occlusive vasculitis was observed. Clinical examination revealed retained intraocular cotton fiber along the inferotemporal quadrant over the retinal surface. In addition to the standard post-operative medications, a course of systemic steroids (40 mg per day of Prednisolone tablets) was started. At the end of the first post-operative week, clinical signs of hemorrhagic retinal vasculitis were beginning to resolve, and by the end of the fourth post-operative week, they had completely resolved.
CONCLUSIONS: This report describes an unusual diagnosis of TPSS after vitreoretinal surgery, most likely due to the presence of an intraocular cotton fiber. This excessive inflammation of the posterior segment usually responds to a course of topical and systemic steroids.
摘要：
背景：眼内炎症在前段或后段手术后很常见。它们通常表现为前段或后段的非感染性炎症，称为毒性前段或后段综合征（TPSS），或无菌或感染性眼内炎。在这份报告中,我们描述了玻璃体视网膜手术后TPSS的罕见病例，表现为出血性视网膜血管炎。
方法：一名58岁男性，诊断为左眼急性孔源性视网膜脱离，在出现的同一天，进行了一次平坦平坦部玻璃体切除术，并进行了硅油内填充。在介绍时,没有眼内炎症的迹象，他在受影响的眼睛的视力是20/200。
结果：在术后第一天，视网膜与硅油很好地附着。沿着视网膜下周边，观察到出血性闭塞性血管炎。临床检查显示，沿着视网膜表面的下颞侧象限保留了眼内棉纤维。除了标准的术后药物，开始一个疗程的全身性类固醇(40mg/天泼尼松龙片剂).术后第一周结束时,出血性视网膜血管炎的临床症状开始消退，在术后第四个星期结束时,他们已经完全解决了。
结论：本报告描述了玻璃体视网膜手术后TPSS的异常诊断，很可能是由于眼内棉纤维的存在。后段的这种过度炎症通常响应于局部和全身性类固醇的过程。
方法：一名58岁男性，诊断为左眼急性孔源性视网膜脱离，在出现的同一天，进行了一次平坦平坦部玻璃体切除术，并进行了硅油内填充。在介绍时,没有眼内炎症的迹象，他在受影响的眼睛的视力是20/200。
结果：在术后第一天，视网膜与硅油很好地附着。沿着视网膜下周边，观察到出血性闭塞性血管炎。临床检查显示，沿着视网膜表面的下颞侧象限保留了眼内棉纤维。除了标准的术后药物，开始一个疗程的全身性类固醇(40mg/天泼尼松龙片剂).术后第一周结束时,出血性视网膜血管炎的临床症状开始消退，在术后第四个星期结束时,他们已经完全解决了。
结论：本报告描述了玻璃体视网膜手术后TPSS的异常诊断，很可能是由于眼内棉纤维的存在。后段的这种过度炎症通常响应于局部和全身性类固醇的过程。
