■要报告严重毒性的非典型表现,前房(AC)炎症,结膜下注射5-氟尿嘧啶(5-FU)引起的视网膜下液的短暂性下凹形成。
■案例介绍。
■小梁切除术后7周,一名40岁的白人男性结膜下注射了5-FU.注射后几分钟内,镜头变成灰色,然后全白。最初,AC很清楚,20分钟后,检测到严重的AC反应。患者每小时服用两次地塞米松滴眼液和托吡卡胺滴眼液。注射后两天,视力改善,AC反应是最小的,晶状体前表面有白色的纤维蛋白,一直延伸到瞳孔边缘。观察到最小的后粘连,在扩张时,晶状体前表面的其余部分看起来完全清晰,表明只有未被虹膜覆盖的晶状体部分显示出纤维蛋白物质和沉积物。注射后一周,由于严重的角膜毒性,视力恶化。晶状体前囊上的白色纤维蛋白材料的尺寸减小,黄斑扫描显示视网膜下积液.两周后,视力明显改善,晶状体前囊上发白的纤维蛋白材料的尺寸进一步减小。视网膜下液已完全消退。
■我们描述了一个罕见的严重毒性病例,AC炎症,5-FU引起的短暂性旁视网膜下液形成。用局部类固醇治疗,尽管AC炎症明显清除,但最终仍存在一定程度的晶状体混浊。
UNASSIGNED: To report an atypical presentation of severe toxicity, anterior chamber (AC) inflammation, and transient parafoveal formation of subretinal fluid induced by the subconjunctival injection of 5-fluorouracil (5-FU).
UNASSIGNED: Case presentation.
UNASSIGNED: Seven weeks after trabeculectomy, a 40-year-old white male had a subconjunctival injection of 5-FU. Within minutes after the injection, the lens turned grey and then total white. Initially, AC was clear, and 20 min later, a severe AC reaction was detected. The patient was prescribed hourly dexamethasone eye drops and tropicamide eye drops twice daily. Two days post-injection, vision improved, AC reaction was minimal, and there was whitish fibrinous material on the anterior surface of the lens, extending up to the pupillary margin. Minimal posterior synechiae were observed, and upon dilation, the remainder of the anterior surface of the lens appeared completely clear, indicating that only the portion of the lens not covered by the iris exhibited fibrinous material and deposits. One week post-injection, vision worsened due to severe corneal toxicity. The dimensions of the whitish fibrinous material on the anterior lens capsule decreased, and macular scans revealed parafoveal subretinal fluid. Two weeks later, vision significantly improved, and the dimensions of the whitish fibrinous material on the anterior lens capsule were further decreased. The subretinal fluid had completely resolved.
UNASSIGNED: We describe a rare
case of severe toxicity, AC inflammation, and transient parafoveal subretinal fluid formation caused by the 5-FU. This was treated with topical steroid treatment, and eventually some level of lens opacification persisted despite significant clearance of the AC inflammation.