背景:大量激光后很少报道严重视力受损的眼部炎症。先前的病例涉及糖尿病性视网膜病变的视网膜光凝治疗数天。该报告记录了一种罕见的情况,其中在没有明显合并症的患者中,进行了环绕视网膜固定/环扎术作为预防眼视网膜脱离的方法。
结果:出现严重的全葡萄膜炎样反应,1例21岁男性在另一只眼表现为视网膜完全脱离,单坐环行激光视网膜固定术/环扎术后1天,记录了近乎完全的视力障碍.激光前的发现并不显著,除了细小的玻璃质凝结物的赤道环。20/20未矫正的激光前视力降低到手部运动,所有象限的光感知,伴有严重的眼前节炎症,后牙膜,玻璃体细胞,和脉络膜积液/可疑渗出性视网膜脱离的B超和超声生物显微镜。口服的组合,topic,和仓库类固醇导致视力恢复1个月后激光,但在激光后第2个月有持续的眼前节炎症和后膜。
结论:作为预防视网膜脱离,激光后炎症和环绕视网膜/环扎术后的多发性后遗症的非典型程度过高,在这种情况下,证明视网膜光凝的效力和风险。激光前评估潜在危险因素的价值,在进行干预时保持谨慎和正念,and,在这种情况下,表现出审慎和彻底的后续行动的价值。
BACKGROUND: Severe vision-impairing ocular inflammation is rarely reported following extensive laser. Previous cases have involved retinal photocoagulation for diabetic retinopathy resolving over days. This report documents a rare instance of this where encircling retinopexy/cerclage was done as fellow eye retinal detachment prophylaxis in a patient with no overt comorbidities.
RESULTS: A panuveitis-like reaction with severe, near-total visual impairment was documented 1 day following single-sitting encircling laser retinopexy/cerclage done as fellow eye prophylaxis for a 21-year-old male presenting with total retinal detachment in the other eye. Pre-laser findings were unremarkable, other than an equatorial ring of fine vitreous condensations. Pre-laser vision of 20/20 uncorrected decreased to hand motion, light perception on all quadrants, accompanied by severe anterior segment inflammation with hypopyon, retrolental membranes, vitreous cells, and choroidal effusion/suspicious exudative retinal detachment on B-scan ultrasound and ultrasound biomicroscopy. Combination of oral, topical, and depot steroids resulted in restoration of vision by 1 month post-laser, but with persistent anterior segment inflammation and retrolental membranes at month 2 post-laser.
CONCLUSIONS: The atypically inordinate degree of post-laser inflammation and multiple sequelae following encircling retinopexy/cerclage as retinal detachment prophylaxis, in this case, demonstrate the potency and risks of retinal photocoagulation. The value of pre-laser assessment for potential risk factors, caution and mindfulness in conducting the intervention, and, the value of prudent and thorough follow-up are exhibited in this case.